A diagnostic-driven approach allows early treatment (in neutropenic patients with or without fever)1-4
A combination of diagnostic assessments is recommended:5
- Routine galactomannan (GM) monitoring every 3-4 days
- Appropriate clinical and microbiological evaluation
- High-resolution computed tomography (CT) imaging
A diagnostic-driven approach has the potential to help you save lives6
- Routine GM screening is shown to lead to the early initiation of antifungal therapy4
- Initiating appropriate treatment on the basis of CT patterns has been shown to save lives*6
- Increased survival was observed in patients with pulmonary invasive aspergillosis who presented with a halo sign versus those with other imaging findings at week 12: 71% vs 53%, respectively (p<0.01)6
*Analysis of chest CT findings at presentation from a large series (n=235) of patients with invasive pulmonary aspergillosis (IPA), to assess the prevalence of a "halo sign" and to evaluate the clinical utility of this imaging finding for early identification and treatment of IPA.6
Vfend® (voriconazole) is not indicated for the empirical treatment of invasive aspergillosis.
Example of a diagnostic-driven antifungal therapy integrated care pathway7
*Check response on day 7. If no response to treatment, further diagnosis is required; if patient responds to treatment, consider the duration of therapy, "step down" therapy, and outpatient follow up.
†Multidisciplinary team input important at this stage.
IFD, invasive fungal disease; IMD, invasive mold disease; PCR, polymerase chain reaction
1. Rogers TR, et al. Br J Haematol. 2011; 153(6): 681–97.
2. Freemantle N, et al. J Antimicrob Chemother. 2011; 66(Suppl 1): i25–35.
3. de Pauw BE& Viscoli C. J Antimicrob Chemother. 2011; 66(Suppl 1): i55–8.
4. Maertens J, et al. Clin Infect Dis. 2005; 41(9): 1242–50.
5. Marchetti O et al. Bone Marrow Transplant. 2012; 47(6): 846–54.
6. Greene RE, et al. Clin Infect Dis. 2007; 44(3): 373–9.
7. Agrawal S, et al. J Antimicrob Chemother. 2011; 66(Suppl 1): i45-53.
8. Vfend® Summary of Product Characteristics.
9. Marks DI, et al. Br J Haematol. 2011; 155(3): 318–27.
10. Herbrecht R, et al. N Engl J Med. 2002; 347(6): 408–15.
Date of Preparation: June 2017
Vfend® (voriconazole) – SPC
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Diflucan® (fluconazole) 10 mg/ml powder for oral suspension – SPC
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Diflucan® (fluconazole) 150 mg Capsules – SPC
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Diflucan® (fluconazole) 2 mg/ml solution for infusion – SPC
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Diflucan® (fluconazole) 200 mg hard capsules – SPC
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Diflucan® (fluconazole) 40 mg/ml powder for oral suspension – SPC
Legal Category: POM Basic NHS cost: Diflucan powder for oral suspension 40 mg/ml £66.42
Diflucan® (fluconazole) 50 mg hard capsules – SPC
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