Resumen de Effectiveness of posaconazole and voriconazole in primary and secondary prophylaxis of invasive fungal infection in hematological patients: Retrospective observational study

E. Chamorro de Vega, María Victoria Gil Navarro, Francisco Javier Bautista Paloma

• Purpose: The primary objective of this study is to evaluate the adaptation of the indication and duration of primary and secondary prophylaxis with posaconazole and voriconazole in hematological patients. Secondarily, to analyze the effectiveness of that prophylaxis.

  Method: Retrospective observational study of hematological patients undergoing antifungal prophylaxis with oral posaconazole and voriconazole in 2011 in a tertiary hospital. According to the reasons for receiving prophylaxis, patients were classified in five groups. Prophylaxis indication and duration were considered appropriate according to the last Clinical Guidelines Consensus for prevention, diagnosis and treatment of infections in patients with hematological malignancies in the hospital. Prophylaxis was considered effective when patients did not develop any fungal infection.

  Results: Thirty-nine patients were recruited, 25 of them received prophylaxis with posaconazole and 14 with voriconazole.

  Prophylaxis indication was appropriate in 32 patients, inappropriate in six and not evaluated in one. The duration was appropriate in seven patients, inappropriate in 26 and not evaluated in six. The prophylaxis was effective in 31 patients; ineffective in six and two could not be evaluated. From the patients with inappropriate duration, 13 exceeded the recommended duration; in 10 patients was shorter, and in three, it could not be determined.

  Conclusions: Indication in prophylaxis is adequate and prevents effectively invasive fungal infection in most of the hematologic patients. On the contrary,duration in most of the patients was inadequate. Effectiveness is greater if the indication is appropriate and higher than recommended durations do not increase the effectiveness