Posaconazole vs. Fluconazole or Itraconazole Prophylaxis in Patients with Neutropenia  

Oleh:

Cornely, Oliver A ; Maertens, Johan ; Winston, Drew J ; Perfect, Johan ; Ullmann, Andrew J. ; Walsh, Thomas J. ; Helfgott, David ; Holowieecki, Jerzy ; Stockelberg, Dick ; Goh, Yeow-Tee ; Petrini, Mario ; Hardalo, Cathy ; Suresh, Ramachandran ; Angulo-Gonzalez, David

Jenis: Article from Journal - ilmiah internasional
Dalam koleksi: The New England Journal of Medicine (keterangan: ada di Proquest) vol. 356 no. 04 (Jan. 2007), page 348.

Ketersediaan

Perpustakaan FK Nomor Panggil: N08.K.2007.01 Non-tandon: 1 (dapat dipinjam: 0) Tandon: tidak ada

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Isi artikel

BACKGROUND Patients with neutropenia resulting from chemotherapy for acute myelogenous leukemia or the myelodysplastic syndrome are at high risk for difficult-to-treat and often fatal invasive fungal infections. METHODS In this randomized, multicenter study involving evaluators who were unaware of treatment assignments, we compared the efficacy and safety of posaconazole with those of fluconazole or itraconazole as prophylaxis for patients with prolonged neutropenia. Patients received prophylaxis with each cycle of chemotherapy until recovery from neutropenia and complete remission, until occurrence of an invasive fungal infection, or for up to 12 weeks, whichever came first. We compared the incidence of proven or probable invasive fungal infections during treatment (the primary end point) between the posaconazole and fluconazole or itraconazole groups; death from any cause and time to death were secondary end points. RESULTS A total of 304 patients were randomly assigned to receive posaconazole, and 298 patients were randomly assigned to receive fluconazole (240) or itraconazole (58). Proven or probable invasive fungal infections were reported in 7 patients (2%) in the posaconazole group and 25 patients (8%) in the fluconazole or itraconazole group (absolute reduction in the posaconazole group, -6%; 95% confidence interval, -9.7 to -2.5%; P

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