Fungal Infections


Previously amphotericin B was considered the first line treatment for aspergillus, however due to its side effect profile alternative agents have been sought. Recent data suggest that for the prevention of invasive fungal infections in at risk patients, voriconazole (a triazole) may be as efficacious (although it should be noted that in the Walsh study, voriconazole failed to meet the stringent statistical criteria of noninferiority) [Walsh TJ et al. NEJM 346: 225, 2002; FREE Full-text at New England Journal of Medicine]. That said, a direct comparison of voriconazole and amphotericin B for the treatment of aspergillus suggested the voriconzole was superior [Herbrecht R et al. NEJM 347: 408, 2002; FREE Full-text at New England Joural of Medicine]