Prophylaxis
High-risk neutropenic patients, such as those undergoing allogeneic and certain autologous stem cell transplants, and those with hematologic malignancy who are expected to have pro longed profound neutropenia, may need prophylactic treatment with antifungal drugs (CA Diekewicz, Clin Infect Dis 2001; 33:139).
The drug of choice for these patients is fluconazole 400 mg PO or IV once daily (JH Rex et al, Clin Infect Dis 2000; 30:662). Itraconazole solution, 200 mg PO or IV once daily, is an alternative but may not be well tolerated. Micafungin has also been effective in this population.