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 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 < 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 < 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.
Chandrasekar
P H
PH
Infectious Diseases/Hematology-Oncology Liaison Unit, Wayne State University School of Medicine, Detroit, Mich.
Gatny
C M
CM
D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D000666:Amphotericin B / Q000627:therapeutic use*; D016470:Bacteremia / Q000517:prevention & control*; D001752:Blast Crisis / Q000150:complications / Q000188:drug therapy; D016026:Bone Marrow Transplantation; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D005334:Fever / Q000517:prevention & control*; D015725:Fluconazole / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007938:Leukemia / Q000150:complications / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000517:prevention & control*; D009503:Neutropenia / Q000150:complications*
D000666:Amphotericin B; D015725:Fluconazole