Aspergillosis Prophylaxis and Treatment for Pediatric HSCT Patients: Environmental and Pharmacologic Options

Hematopoietic stem cell transplant (HSCT) recipients are at increased risk of viral, bacterial, fungal, and parasitic infections both pretransplant and post-transplant. One of the most dangerous infections that can be acquired during this time is aspergillosis. Several drugs are available for prophylaxis, though no particular regimen has been proven to be superior; although the CDC has clear recommendations regarding prophylaxis for many other infections (such as cytomegalovirus, herpes simplex, toxoplasmosis, and Candida) for HSCT patients, there are none for aspergillosis. Researchers have varying opinions as to which drugs are best for prophylaxis. In this article, pharmacologic and environmental options for prophylaxis are discussed as well as antifungals currently in use, and recommendations on how nurses can help keep their patients safe from this infection are given.