[The impact of itraconazole versus fluconazole on the prevention of postoperative invasive fungal infections after orthotopic liver transplantation].
OBJECTIVE
To compare the efficiency and safety of itraconazole oral solution with those of fluconazole to prevent invasive fungal infections (IFI) in postoperative patients receiving orthotopic liver transplantation (OLT).


METHODS
In a randomized, controlled, open trial, 60 patients receiving OLT were randomized into itraconazole treatment group (n = 30) and fluconazole treatment group (n = 30). The patients in itraconazole treatment group were given itraconazole oral solution in a dose of 20 ml once a day for 15 days and the patients in the fluconazole treatment group were given fluconazole in a dose of 150 mg once a day also for 15 days. The incidences of fungal infections after liver transplantation and the resistance to drugs were recorded.


RESULTS
There were three patients in the itraconazole treatment group getting IFI; the infection rate was 10.0%. One patient had confirmed diagnosis and two other patients were diagnosed clinically. In the fluconazole treatment group there were 10 patients getting IFI, the infection rate was 33.3%. Two patients had confirmed diagnosis, six patients were diagnosed clinically and the remaining two were diagnosed tentatively. There was a significant difference between the two groups (P < 0.05).


CONCLUSIONS
Compared with fluconazole, itraconazole oral solution is more effective in the treatment of invasive fungal infections in postoperative patients receiving OLT.
Cai
Chang-jie
CJ
Liver Transplantation Center, the Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, China.
Yi
Shu-hong
SH
Guo
Yi
Y
Li
Min-ru
MR
Yi
Hui-min
HM
Yang
Yang
Y
Lu
Min-qiang
MQ
Chen
Gui-hua
GH
D000328:Adult; D000368:Aged; D000935:Antifungal Agents / Q000008:administration & dosage / Q000627:therapeutic use; D004334:Drug Administration Schedule; D005260:Female; D015725:Fluconazole / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D017964:Itraconazole / Q000008:administration & dosage / Q000627:therapeutic use*; D016031:Liver Transplantation / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000209:etiology / Q000517:prevention & control*; D011183:Postoperative Complications / Q000209:etiology / Q000517:prevention & control; D011446:Prospective Studies; D016896:Treatment Outcome
D000935:Antifungal Agents; D017964:Itraconazole; D015725:Fluconazole