Prevention and mycoses in immunocompromised patients.

Invasive fungal infections remain a major complication in immunocompromised hosts. The prognosis in these infections is poor, particularly for neutropenic patients with cancer. Candidiasis and aspergillosis are common in these patients, and numerous attempts have been made to evaluate potential prophylactic methods. Despite the fact that various agents (polyenes and/or imidazoles) and various formulations have been tested, the reported data on their effectiveness are still controversial. No single regimen can be recommended at this time for prevention of invasive candidiasis. The potential emergence of fungal strains resistant to the polyenes and the selection of Torulopsis glabrata by the imidazoles should also be taken into consideration. Aspergillosis, which is an airborne infection, may be prevented by isolation of patients at risk in rooms equipped with high-efficiency particulate air (HEPA) filters. In addition, the prophylactic administration of nasal sprays of amphotericin B has shown encouraging results, and this approach should be further investigated.