새로운 항진균제 도입 이후 호중구감소증 발열 환자의 경험적 항진균요법과 침습적 진균감염의 연구

Abstract

Background: Patients with prolonged empirical broad spectrum antibiotics for febrile neutropenia (FN) with cancer, inevitably have increased risk of invasive fungal infections owing to the altered endogenous microbial environment.

Objective: The purpose of this study is to evaluate the impact of empirical antifungal therapy on occurrence of invasive fungal infections (IFIs) during FN with cancer.

Methods: We retrospectively reviewed medical records of patients with FN after cytotoxic chemotherapy due to cancer from July, 2003 to June, 2007.

Results: We identified 91 patients with FN after cytotoxic chemotherapy. Most common underlying conditions were lymphoma (20/91, 22%) and leukemia (20/91, 22%). IFIs occurred in 10% (9/91). In a comparison of patients with empirical antifungal therapy with no antifungal therapy, the duration of neutropenia was significantly increased with IFIs (p=0.09). The mortality of IFIs was 55.5% (5/9).

Conclusion: We found that the duration of FN than empirical antifungal therapy affected occurrence of IFIs.