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


, : Effect of fluconazole prophylaxis on fever and use of amphotericin in neutropenic cancer patients. Chemotherapy 40(2): 136-143

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.

Accession: 002355876

DOI: 10.1159/000239184

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Related references

Chandrasekar, P.H.; Gatny, C.M., 1994: Effect of fluconazole prophylaxis on fever and use of amphotericin in neutropenic cancer patients. Bone Marrow Transplantation Team. 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 leuke...

Chandrasekar P.H.; Gatny C.; Kruse J.A.; Bone Marrow Transplant Team, 1991: Reduction in use of amphotericin amb with fluconazole f prophylaxis in neutropenic cancer patients pts. Program & Abstracts of the Interscience Conference on Antimicrobial Agents & Chemotherapy 31: 222

Rotstein, C.; Bow, E.J.; Laverdiere, M.; Ioannou, S.; Carr, D.; Moghaddam, N., 1999: Randomized placebo-controlled trial of fluconazole prophylaxis for neutropenic cancer patients: benefit based on purpose and intensity of cytotoxic therapy. The Canadian Fluconazole Prophylaxis Study Group. A randomized, double-blind trial comparing oral fluconazole (400 mg daily) with placebo as prophylaxis for adult patients receiving intensive cytotoxic therapy for acute leukemia or autologous bone marrow transplantation was conducted in 14 Canadi...

Chandrasekar, P.H.; Gatny, C.M.; Team, T.B.ne Marrow Tranpslantation, 1994: The effect of fluconazole prophylaxis on fungal colonization in neutropenic cancer patients. The impact of prophylaxis with 400 mg/day fluconazole on fungal colonization at different body sites was assessed in a randomized, double-blind, placebo controlled study among patients with leukaemia and those undergoing bone marrow transplantatio...

Stemmer, S.M.; Hardan, I., 1996: Oral fluconazole, rather than intravenous amphotericin B , as empiric antifungal treatment for neutropenic fever in breast cancer patients undergoing high dose chemotherapy and autologous hematopoietic stem cell transplant. Blood 88(10 SUPPL 1 PART 1-2): 265B

Finke, R., 1990: Comparison of oral fluconazole and amphotericin B prophylaxis against fungal infections in the neutropenic phase of patients treated with antileukemic agents. Forty patients with acute leukemia (age 16-71 years, 13 females, 27 males) with induced neutropenia due to chemotherapy received either 50 mg fluconazole or 800 mg amphotericin B per day orally as prophylaxis against fungal infection. Nasal and ge...

Menichetti F.; Martino P.; Del Favero A.; Gimema Infect Program (Italy), 1992: Fluconazole flu vs oral amphotericin b o amb for antifungal prophylaxis in neutropenic pts. Program & Abstracts of the Interscience Conference on Antimicrobial Agents & Chemotherapy 32: 215

Chandrasekar, P.H.; Gatny, C.M., 1994: The effect of fluconazole prophylaxis on fungal colonization in neutropenic cancer patients. Bone Marrow Transplantation Team. The impact of prophylaxis with 400 mg/day fluconazole on fungal colonization at different body sites was assessed in a randomized, double-blind, placebo controlled study among patients with leukaemia and those undergoing bone marrow transplantatio...

Johansen, H.K.; Gotzsche, P.C., 2000: Amphotericin B vs fluconazole for controlling fungal infections in neutropenic cancer patients. Systemic fungal infection is considered to be an important cause of morbidity and mortality in cancer patients, particularly those with neutropenia. Antifungal drugs are often given prophylactically, or to patients with persistent fever. To compar...

Johansen, H.Krogh.; Gøtzsche, P.C., 2015: Amphotericin B versus fluconazole for controlling fungal infections in neutropenic cancer patients. Systemic fungal infection is considered to be an important cause of morbidity and mortality in cancer patients, particularly those with neutropenia. Antifungal drugs are often given prophylactically, or empirically to patients with persistent feve...