title: The efficacy of itraconazole against systemic fungal infections in neutropenic patients: a randomised comparative study with amphotericin B.
abstract: In a randomised clinical trial, we compared the efficacy of the new triazole drug itraconazole (200 mg orally twice daily) with that of amphotericin B (0.6 mg/kg daily or 0.3 mg/kg in combination with flucytosine) in neutropenic (less than 500 x 10(6)/l neutrophils) patients with proven or highly suspected systemic fungal infections. 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 49 years) were treated with itraconazole for a median period of 20 days and 16 patients (median age 32 years) received amphotericin B for a median period of 13 days. The overall clinical response was 10/16 (63%) for patients treated with itraconazole and 9/16 (56%) for patients treated with amphotericin B (P greater than 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.
authors.affiliation: Department of Infectious Diseases, University Hospital Leiden, The Netherlands.
authors.forename: J W
authors.initials: JW
authors.lastname: van't Wout
authors.forename: I
authors.initials: I
authors.lastname: Novakova
authors.forename: C A
authors.initials: CA
authors.lastname: Verhagen
authors.forename: W E
authors.initials: WE
authors.lastname: Fibbe
authors.forename: B E
authors.initials: BE
authors.lastname: de Pauw
authors.forename: J W
authors.initials: JW
authors.lastname: van der Meer
mesh_terms: D000666:Amphotericin B / Q000627:therapeutic use*; D001228:Aspergillosis / Q000150:complications / Q000188:drug therapy*; D001232:Aspergillus fumigatus; D002177:Candidiasis / Q000150:complications / Q000188:drug therapy*; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D005260:Female; D005437:Flucytosine / Q000627:therapeutic use; D006801:Humans; D017964:Itraconazole; D007654:Ketoconazole / Q000031:analogs & derivatives* / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000150:complications*; D011446:Prospective Studies
chemical_list: D017964:Itraconazole; D000666:Amphotericin B; D005437:Flucytosine; D007654:Ketoconazole