title: Impact of fluconazole versus posaconazole prophylaxis on the incidence of fungal infections in patients receiving induction chemotherapy for acute myeloid leukemia.
abstract: BACKGROUND
  Invasive fungal infections (IFIs) remain one of the worrying complications in patients with acute myeloid leukemia (AML) due to their incidence and high level of attributable mortality. In light of these risks, antifungal prophylaxis has always been debated. We conducted a single-center retrospective study of two prophylactic antifungal agents (fluconazole/posaconazole) in 91 consecutive patients receiving induction chemotherapy for AML between 2005 and 2009, in order to evaluate the impact on the incidence of IFI and on the mycological flora of the patients.
  
  
  METHODS
  In total, 39 patients received prophylactic fluconazole versus 52 who received posaconazole. The baseline characteristics of the two groups were comparable.
  
  
  RESULTS
  Overall, 17 patients developed an IFI, with no difference in frequency between the two groups. Utilization of empirical or pre-emptive therapy was similar irrespective of the type of prophylaxis used. Mycological examination of stools revealed an increase in non-albicans Candida colonization in the fluconazole group during hospitalization and the appearance of Saccharomyces cerevisiae colonization in patients receiving posaconazole.
  
  
  CONCLUSIONS
  The present study does not distinguish between fluconazole and posaconazole as a primary effective prevention against fungal infections. More prospective studies and meta-analyses are warranted.
authors.forename: Camille
authors.initials: C
authors.lastname: Devanlay
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Tavernier-Tardy
authors.forename: Aurélie
authors.initials: A
authors.lastname: Bourmaud
authors.affiliation: Departement of Radiation Oncology, Centre Antoine Lacassagne, Nice, France.
authors.forename: Alexander Tuan
authors.initials: AT
authors.lastname: Falk
authors.forename: Hélène
authors.initials: H
authors.lastname: Raberin
authors.forename: Sandrine
authors.initials: S
authors.lastname: Menguy
authors.forename: Denis
authors.initials: D
authors.lastname: Guyotat
authors.forename: Nicolas
authors.initials: N
authors.lastname: Magné
authors.forename: Jérôme
authors.initials: J
authors.lastname: Cornillon
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000935:Antifungal Agents / Q000627:therapeutic use*; D005260:Female; D015725:Fluconazole / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D015994:Incidence; D060828:Induction Chemotherapy; D015470:Leukemia, Myeloid, Acute / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000188:drug therapy* / Q000453:epidemiology; D012189:Retrospective Studies; D014230:Triazoles / Q000009:adverse effects / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D000935:Antifungal Agents; D014230:Triazoles; C101425:posaconazole; D015725:Fluconazole