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New Guidelines for the Management of Bacterial, Fungal and Viral Infections: ECIL-2 Sept 28-29, 2007 • Juan-de-Pins, France The first European Conference on Infections in Leukemia (ECIL1) held in 2005 was organized under the auspices of the Infectious Disease Group of the EORTC, the Infectious Diseases Working Party of the European Group for Blood and Marrow Transplantation (EBMT), the Supportive Care group of the European Leukemia Net (ELN) and the Immunocompromised Host Society (ICHS) with the objective to develop guidelines for the management of bacterial and fungal infections in populations of high risk immunocompromised patients.

The ECIL-1 guidelines resulted from the collaboration of six working groups who reviewed data from the literature to answer specific questions on the prevention and treatment of bacterial and invasive fungal infections, which are major causes of morbidity and mortality in leukemic patients. Data from large prospective trials and meta-analyses were evaluated and the conclusions presented and debated at the ECIL-1 conference by an expert panel of 59 infectious diseases specialists, microbiologists, clinical trial specialists and hematologists from 24 European countries, Israel and Australia. After consensus was reached, the guidelines were finalized and each proposal scored for level of evidence and recommendation based on the Centre for Disease Control and Prevention (CDC) grading system. 

ECIL-1 addressed six topics, three relating to bacterial infections and three relating to fungal infections (Cordonnier C., Calandra T., Meunier F. Guidelines from the First European Conference on Infections in Leukaemia: ECIL1. EJC Supplements 2007; 5(2): 1-60). The ECIL-2 guidelines provide updated recommendations on empirical antifungal therapy, antifungal prophylaxis and the antifungal treatment of Aspergillus and Candida infections. It also addresses two additional areas, the management of Herpes virus infections (HSV, VZV, CMV, HHV6 and 7, EBV) as well as the management of other viral infections including Respiratory viruses, Influenza virus, Polyoma and Parainfluenza virus. The following slides sets are the most updated presentations of ECIL-2 based on the recent meeting held on September 28-29, 2008 in Juan-de-Pinas, France.

INTRODUCTION:

Introduction to ECIL 1 and ECIL 2 (146KB)

ANTIVIRAL TREATMENT:

Recommendationsfor HSV management (127KB)

Working Group: Pierre Reusser, Dan Engelhard, Rafael de la Camara, Hermann Einsele, Jan Styczynski, Kate Ward, Per Ljungman

Recommendations for CMV management (229KB)

Working Group: Per Ljungman, Rafael de la Camara, Hermann Einsele, Dan Engelhard, Pierre Reusser, Jan Styczynski, Kate Ward

Recommendations for EBV management (301KB)

Working Group: Jan Styczynski, Hermann Einsele, Rafael de la Camara, Dan Engelhard, Pierre Reusser, Kate Ward, Per Ljungman

Recommendations for VZV management (135KB)

Working Group: Dan Engelhard, Pierre Reusser, Rafael de la Camara, Hermann Einsele, Jan Styczynski, Kate Ward, Per Ljungman

ANTIFUNGAL THERAPY:

UPDATE 2007: Antifungal Therapy (241KB)

Working Group: Raoul Herbrecht, Ursula Flückiger, Bertrand Gachot, Patricia Ribaud, Anne Thiebaut, Catherine Cordonnier

UPDATE 2007: Empiric Antifungal Therapy (269KB)

Working Group: O. Marchetti, C. Cordonnier, T. Calandra

UPDATE 2007: Antifungal Prophylaxis (344KB)

Working Group: Johan Maertens (B, chair), Pascale Frére (B), Cornelia Lass-Flörl (Au), Werner Heinz (D), Oliver Cornely (D, co-chair)

ANTIBACTERIAL TREATMENT:

Empirical antibacterial treatment - Aminoglycosides (137KB)

L. Drgona

Empirical Antibacterial Treatment: Glycopeptides (212KB)

A.Cometta, O.Marchetti, T.Calandra

NEUTROPENIA:

Fluoroquinolone Prophylaxis In neutropenic patients (286KB)

For the working group Giampaolo Bucaneve

Disclaimer

These guidelines reflect the state of knowledge, current at the time of publication, on effective and appropriate care, as well as clinical consensus judgements when knowledge is lacking. The inevitable changes in the state of scientific information and technology, mandate that periodic review, updating, and revisions will be needed. These guidelines do not apply to all patients, and each must be adapted and tailored to each individual patient. Proper use, adaptation modifications or decisions to disregard these or other guidelines, in whole or in part, are entirely the responsibility of the clinician who uses the guidelines.