Comparison of fluconazole with oral polyenes in the prevention of fungal infections in neutropenic patients A prospective, randomized, single-center study

摘要: The goal of this prospective randomized single-center study was the comparison safety and efficacy high-dose oral/intravenous fluconazole (400 mg daily) (group A) with oral nystatin plus miconazole inhalations B) in prevention fungal infections on a hemato-oncological isolation Ward. Of 157 patients admitted to ward during period only 90 (57%) were eligible for randomization; 22 (14%) had infection at admission. patients, 89 evaluable, 43 group A 46 B. age, sex, diagnosis, planned therapy risk factors admission as well duration neutropenia same proportions both groups. Oral thrush mucocutaneous candidiasis prevented all groups, 29 (32%: 17 A, 12 discharged after successful prophylaxis (NS). Empiric amphotericin B given according predetermined criteria 45 (51%: 23 B; NS). Fluconazole significantly delayed time before start intravenous It begun median 10 days (0–45 days, range) below 0.5x109 granulocytes/l 7.5 (0–26, (P<0.05). longer (26 median) than (21 Systemic documented 3 (1 2 Colonisation Candida persisted more 14 or occurred de novo 1 patient 7 be discontinued because intolerance fluconazol stopped increased liver values one patient. Compliance worse (P<0.01) 82% dose compared 99% A. Both regimens successfully complications. better tolerated need empiric Neither approach cancelled use nor colonization. occur probably independently candidiasis.