Effect of fluconazole prophylaxis on fever and use of amphotericin in neutropenic cancer patients

Chandrasekar, P. H.; Gatny, C. M.

We studied the impact of fluconazole prophylaxis (400 mg/day) on clinical features including fever and use of amphotericin in a randomized, double-blind, placebo-controlled (1:1 randomization) study among patients undergoing chemotherapy for leukemia and those undergoing bone marrow transplantation. Fluconazole or placebo was given throughout the period of neutropenia. Amphotericin was administered to 5 of 23 (22%) fluconazole recipients and 14 of 23 (58%) placebo recipients (p lt 0.01). Median duration of amphotericin used in fluconazole and placebo groups was 9 days (mean 10.8) and 13 days (mean 14) respectively. Patients who received fluconazole had significantly shorter duration of fever prior to treatment with amphotericin (days, median 5 vs. 9, p lt 0.05). Superficial fungal infections were noted in 8 (34%) fluconazole recipients and 19 (79%) placebo recipients (p = 0.002). Fluconazole was well tolerated. Prophylaxis with fluconazole resulted in a significant reduction in the empiric use of amphotericin, duration of fever and incidence of superficial fungal infections.

Effect of fluconazole prophylaxis on fever and use of amphotericin in neutropenic cancer patients

Chandrasekar, P.H.; Gatny, C.M., 1994: Effect of fluconazole prophylaxis on fever and use of amphotericin in neutropenic cancer patients. Chemotherapy 40(2): 136-143

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