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Cancer patients treated with chemotherapy or who receive a bone marrow transplant have an increased risk of acquiring fungal infections. Such infections can be life‐threatening. Antifungal drugs are therefore often given prophylactically to such patients, or when they have a fever. The review could not detect a difference in effect between amphotericin B and fluconazole but several of the trials were designed or analysed in a way that disfavoured amphotericin B, which is the only antifungal drug that has been shown to have an effect on mortality.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2017

Patients with cancer who are treated with chemotherapy or receive a bone marrow transplant have an increased risk of fungal infections. Such infections can be life‐threatening. Antifungal drugs are therefore often given to prevent fungal infections in such patients, either when these patients are known to have a fungal infection or when such an infection is suspected. We reviewed the evidence about the effect of voriconazole compared to amphotericin B or fluconazole to prevent or treat fungal infections in cancer patients with a poor immune system to provide defence.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

Invasive fungal infections ‐ infections of the bloodstream and organs within the body (e.g. meningitis, pneumonia, peritonitis) ‐ are important causes of morbidity and mortality in liver, pancreas, heart, kidney and lung (i.e. solid organ) transplant recipients. This review found that fluconazole, used as a preventive drug, significantly reduced the number of invasive fungal infections in liver transplant patients. More studies are needed to determine how effective antifungal drugs are for pancreas, heart, kidney and lung transplant patients.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Infection with the human immunodeficiency virus (HIV) leads to progressive destruction and weakening of the body's immune system. Patients with advanced HIV disease are vulnerable to various diseases, called opportunistic infections (OIs), which most people with normal immune systems are protected against. One of these OIs, a fungal disease called cryptococcosis, causes meningitis (an inflammation of the membrane surrounding the brain) and pneumonia and is lethal when untreated. This study looked at two medications, itraconazole and fluconazole, which could be taken by patients with advanced HIV disease, to prevent this fungal infection from ever occurring. This study found that both were effective drugs for preventing cryptococcal disease. However, these drugs were not found to be effective in decreasing the overall death rates from HIV. More studies of these medications are needed to further evaluate their cost‐effectiveness and benefits in decreasing death rates in groups of patients with HIV.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2009

Background: Fungi such as candida (the organism that causes thrush) can cause severe infections in very low birth weight infants (birth weight less than 1.5 kg). These infections are often difficult to diagnose. It may be appropriate to attempt to prevent such infections by giving all very low birth weight infants antifungal drugs as a routine part of their care (systemic antifungal prophylaxis). This review assessed whether evidence exists that such a practice prevents severe fungal infection, death, and disability in very low birth weight infants.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Despite the advent and increasingly wide availability of antiretroviral therapy for people with HIV/AIDS, cryptococcal meningitis remains a significant cause of death and illness amongst individuals with HIV infection in resource‐limited settings (poor countries). The ideal way to manage cryptococcal meningitis remains unclear. The main aim of this review was to determine the best treatment for cryptococcal meningitis in resource‐limited settings. In these settings, usually only Amphotericin and fluconazole are available. The authors didn't find any suitable studies that compared these two drugs. Because Flucytosine, which works well with Amphotericin, is often not available in poor countries, policy makers and government officials should consider using this drug for HIV treatment programmes. Future research into the management of cryptococcal meningitis in resource‐limited settings should focus on the most effective use of medications that are available in these settings.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

People on chemotherapy for cancer, receiving a transplant or with AIDS are at risk of fungal infections. These infections can be life‐threatening, especially when they spread throughout the body. Nystatin is sometimes given as a routine preventive measure or as treatment in these patients. The review found that nystatin was no better than placebo (no treatment).

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2017

Vulvovaginal candidiasis (VVC) / thrush is one of the most common fungal infections and recurs frequently in women with human immunodeficiency virus (HIV) infection. Even though rarely or never resulting in systemic fungal infection or mortality, interventions for prevention and treatment of this condition is an essential part of maintaining the quality of life of such individuals.This review was aimed at evaluating such interventions.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Preterm and sick newborn infants are at risk of serious infections of the blood, brain and kidneys due to fungi such as Candida (the organism that causes thrush). Severe fungal infections are associated with high death rates and with long‐term brain damage in newborn infants. A variety of different types of drugs for treating fungal infections are available. However, this systematic review found only very limited evidence (one small trial) to support the use of one type of antifungal drug over another. Until this uncertainty is resolved with new large trials, clinicians may continue to base their choice of antifungal agent on data extrapolated from studies in older children and adults.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2012

Background: Fungi such as candida (the organism that causes thrush) can cause bloddstream and other severe infections in VLBW infants (birth weight less than 1500 grams). These infections are often difficult to diagnose and frequently cause death or disability. Therefore, it may be appropriate to attempt to prevent such infections by giving VLBW infants antifungal drugs as a routine part of their care. This review assessed specifically the effect of giving infants antifungal drugs that reduce skin and gut carriage of fungi to reduce the chances of a severe infection developing.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Babies in the neonatal intensive care unit require medicines and fluids through their veins. To do this, a small tube (described as a central venous catheter, CVC) is inserted into the infant's vein through the umbilical cord or through the skin. This tube is placed just outside the heart. This tube is then used to give medicines and fluid without causing any discomfort. However, this tube does lead to an increased risk of infection, which can be life threatening. There are many measures taken to try to prevent this, but infection still occurs. This review looks at one way to prevent this infection by putting an antibiotic solution into the tube and leaving it to stay there for a certain length of time (called antibiotic lock) compared with a solution containing no antibiotic.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2015

Tinea capitis, or ringworm, is a fungal infection of the scalp caused mainly by two species of fungi called Trichophyton and Microsporum. It is common in children. Most fungal infections can be treated with antifungal creams applied directly to the skin (topical treatments). However, because the fungal infection is found at the root of the hair follicles, where topical treatments cannot reach, tinea capitis always requires medication administered by mouth so that the treatment spreads throughout the entire body (systemic treatments). There are several different types of antifungal medicines available.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2016

We reviewed the evidence about the effect of giving antifungal medications before a definitive diagnosis of fungal infections on mortality from all causes and development of severe infections due to fungi (invasive fungal infections) in adults and children who are critically ill but non‐neutropenic, i.e. with a normal number of neutrophils in their blood.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2017

Nail fungus can be very persistent. Topical treatment with nail polish may last as long as one year. Tablets for treating fungal nail infections usually have to be taken for several weeks or months. They are much more effective than topical treatments, but they have more side effects.Crumbly nails and a whitish-yellowish to brownish discoloration are typical signs of nail fungus. The nails may also become thicker and change shape. The affected part of the nail can become detached from the nail bed. Treatment options for nail fungus include nail polishes and creams as well as tablets. Nail polishes and creams are available in pharmacies without a prescription.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: January 14, 2015

If someone is at higher risk of developing oral thrush, it is a good idea to try to take preventive measures. Aside from various forms of oral hygiene, antimycotics (antifungal drugs) can be used to prevent oral thrush. These medications can also be used to treat this infection.Oral thrush, also known as candidiasis, is a fungal infection in the mouth and throat area. It is caused by types of yeast fungus called Candida that grow on the mucous membranes lining the mouth and throat. Many people have a small amount of this kind of fungus on their mucous membranes without having any noticeable problems. But given the right conditions, the yeast fungus can start reproducing very quickly. The infection appears as a white coating and red inflamed areas in the mouth and throat region. It is sometimes painful and can impair your sense of taste, as well as making it difficult to speak or eat.The risk of oral thrush is higher in people who have a weakened immune system, for instance due to a chronic disease or an intensive treatment such as chemotherapy. It is also common in people who have HIV/AIDS, and is often quite distressing. Some end up eating very little because of the pain in their mouth and throat, which can make their body even weaker.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: May 18, 2016

Tinea versicolor can usually be effectively treated using topical (externally applied) medications. These contain a substance that keeps the fungus from growing or kills it. Even with treatment, it can take several months for the skin to return to normal.Tinea versicolor is a skin condition that affects about 1% of the population in countries with a moderate climate. The main symptom is discolored (lighter or darker) patches of skin, mostly on the upper body. It is caused by a type of fungus that is found on most people’s skin. Tinea versicolor is not contagious.

Informed Health Online [Internet] - Institute for Quality and Efficiency in Health Care (IQWiG).

Version: June 1, 2017

Oral candidiasis (thrush) associated with human immunodeficiency virus (HIV) infection occurs commonly and recurs frequently, often presenting as an initial manifestation of the disease. Interventions aimed at preventing and treating HIV‐associated oral thrush form an integral component of maintaining the quality of life for affected individuals. This review evaluated the effects of interventions in preventing or treating oral thrush in children and adults with HIV infection. Thirty three trials (n=3445) were included. Twenty two trials investigated treatment and eleven trials investigate prevention. There was no difference with regard to clinical cure between fluconazole compared to ketoconazole, itraconazole, clotrimazole and posaconazole. Fluconazole, gentian violet and ketoconazole were superior to nystatin. Compared to placebo and no treatment, fluconazole was effective in preventing clinical episodes from occurring. Continuous fluconazole was better than intermittent treatment. Insufficient evidence was found to come to any conclusion about the effectiveness of clotrimazole, nystatin, amphotericin B, itraconazole, ketoconazole or chlorhexidine with regard to OC prophylaxis.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2011

Cancer patients receiving chemotherapy or a bone marrow transplant are at risk of fungal infections. These can be life‐threatening, especially when they spread throughout the body. Those patients with low white cell counts (neutropenia) are particularly at risk. Antifungal drugs are often given as a routine preventive measure, or when people who are at risk have a fever. The review found that intravenous amphotericin B could reduce the number of deaths. Three of the drugs, amphotericin B, fluconazole and itraconazole, reduced fungal infections.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2017

In this Cochrane Review, we assessed the effect and safety of probiotics for the treatment of vulvovaginal candidiasis (VVC) in non‐pregnant women compared with conventional antifungal drugs, or probiotics used to change the effects of conventional antifungal drugs.

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2017

We reviewed the evidence for suppression of the stress system/hypothalamic‐pituitary‐adrenal (HPA) axis (how often does it happen? how long does the suppression persist?) after treatment with synthetic stress hormones/glucocorticoids in children with acute lymphoblastic leukaemia (ALL).

Cochrane Database of Systematic Reviews: Plain Language Summaries [Internet] - John Wiley & Sons, Ltd.

Version: 2017

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