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Posaconazole vs. Fluconazole or Itraconazole Prophylaxis in Patients with Neutropenia
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Posaconazole vs. Fluconazole or Itraconazole Prophylaxis in Patients with Neutropenia
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Journal Article
Posaconazole vs. Fluconazole or Itraconazole Prophylaxis in Patients with Neutropenia
2007
Overview
In this randomized trial of patients undergoing treatment for acute myelogenous leukemia or the myelodysplastic syndrome, prophylaxis with posaconazole resulted in fewer fungal infections and longer survival than did prophylaxis with fluconazole or itraconazole. The difference was primarily due to a lower rate of invasive aspergillosis in the posaconazole group.
In patients undergoing treatment for acute myelogenous leukemia or the myelodysplastic syndrome, prophylaxis with posaconazole resulted in fewer fungal infections and longer survival than did prophylaxis with fluconazole or itraconazole.
Invasive fungal infections remain a major cause of illness and death in patients with neutropenia who have hematologic cancers, despite the availability of new antifungal agents. The incidence of proven or probable mold and yeast infections can reach 24% among patients with leukemia.
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Reported mortality from candidiasis or aspergillosis ranges from 40 to 50%, and mortality from fusariosis or zygomycosis is 70% or more.
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Prophylaxis is a commonly used treatment strategy, because the diagnosis of fungal infection is often delayed or difficult to establish with certainty, and a delay in antifungal treatment increases mortality.
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Antifungal prophylaxis with . . .
Publisher
Massachusetts Medical Society
Subject
/ Adult
/ Aged
/ Antibiotics. Antiinfectious agents. Antiparasitic agents
/ Antifungal Agents - adverse effects
/ Antifungal Agents - therapeutic use
/ Antineoplastic Agents - adverse effects
/ Biological and medical sciences
/ Female
/ Fluconazole - adverse effects
/ Fluconazole - therapeutic use
/ Fungi
/ Humans
/ Itraconazole - adverse effects
/ Itraconazole - therapeutic use
/ Leukemia, Myeloid, Acute - complications
/ Leukemia, Myeloid, Acute - drug therapy
/ Leukemia, Myeloid, Acute - mortality
/ Male
/ Mycoses - prevention & control
/ Myelodysplastic Syndromes - complications
/ Myelodysplastic Syndromes - drug therapy
/ Myelodysplastic Syndromes - mortality
/ Neutropenia - chemically induced
/ Opportunistic Infections - prevention & control
