Objective: To investigate the efficacy of intravenous administration of itraconazole on fungal infections in immunocompromised patients with hematological diseases according to stratified diagnoses.
Methods: Twenty-five patients with hematological diseases who were diagnosed according to the criteria of European Organization for Research and Treatment of Cancer (EORTC), including 6 cases with confirmed diagnosis diagnosis, 12 cases with clinical diagnosis, and 7 cases with recommended diagnosis, underwent intravenous injection of itraconazole 125 approximately 200 mg bid for 2 days and then qd for at most 2 weeks and then oral administration of itraconazole 0.4 g/day for at most 2 weeks, and then the repeated regimen with a course of treatment of 1 approximately 3 months from 2002 to 2004. Eighteen cases were diagnosed with lung infection, 1 case with sinuses and trachea infection, and the infection sites were not documented for other 7 cases. The clinical results were analyzed.
Results: The effective rates of the patients with confirmed diagnosis, with clinical diagnosis, and with recommended diagnosis were 66.7% (4/6), 83.3% (10/12), and 14.3% (1/7) respectively. The effective rates of the patients with major imaging signs and those with secondary imaging signs were 90.0% (9/10) and 97.1% (4/7). There was a significant difference between the curative effects of the patients with confirmed diagnosis and those with recommended diagnosis (P = 0.006).
Conclusion: Fungal infections in immunocompromised patients with hematological diseases can be successfully treated with intravenous administration of itraconazole.