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The efficacy of itraconazole against systemic fungal infections in neutropenic patients: a randomised comparative study with amphotericin B

, : The efficacy of itraconazole against systemic fungal infections in neutropenic patients: a randomised comparative study with amphotericin B. Journal of Infection 22(1): 45-52

In a randomized clinical trial, the efficacy of itraconazole (200 mg orally twice daily) was compared with that of amphotericin B (Fungizone) (0.6 mg/kg daily or 0.3 mg/kg in combination with flucytosine (Ancotil)) in neutropenic (<500 x 106/litre neutrophils) patients with proven or highly suspected systemic fungal infections (15 Candida albicans, 1 Candida, 7 Aspergillus fumigatus, 1 A. niger, 1 A. flavus, 4 Aspergillus and 3 unidentified). Patients with unexplained fever alone were not included in the study. Of the 40 patients enrolled, 32 patients (16 males, 16 females) were evaluable. Sixteen patients (median age 51 yrs) were treated with itraconazole for a median period of 20 d and 16 patients (median age 32 yrs) received amphotericin B for a median period of 13 d. The overall clinical response was 10 of 16 (63%) for patients treated with itraconazole and 9 of 16 (56%) for patients treated with amphotericin B (P>0.90). Itraconazole seemed to be more effective against Aspergillus infections, whereas amphotericin B seemed to be more effective against candidal infections, although the differences were not statistically significant.

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Accession: 002249703

DOI: 10.1016/0163-4453(91)90954-q

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