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Posaconazole or Fluconazole for Prophylaxis in Severe Graft-versus-Host Disease
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Journal Article
Posaconazole or Fluconazole for Prophylaxis in Severe Graft-versus-Host Disease
2007
Overview
This randomized, double-blind trial of prophylaxis to prevent invasive fungal infections was conducted in 600 patients with severe graft-versus-host disease after hematopoietic stem-cell transplantation. Posaconazole, an extended-spectrum triazole, was as effective as fluconazole in preventing invasive fungal infections (incidence, 5.3% and 9.0%, respectively). With posaconazole, there were fewer cases of invasive aspergillosis infections.
In patients with severe graft-versus-host disease, posaconazole was as effective as fluconazole in preventing invasive fungal infections. With posaconazole, there were fewer cases of invasive aspergillosis infections.
Invasive fungal infections remain one of the leading causes of death among recipients of hematopoietic stem-cell transplants.
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In these patients, factors associated with complications resulting from transplantation, such as prolonged neutropenia, graft failure, immunosuppression, and graft-versus-host disease (GVHD), increase the risk of an invasive fungal infection.
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Randomized, controlled trials have shown the superiority of fluconazole over placebo for the prevention of fungal infections, primarily those caused by candida species, after hematopoietic stem-cell transplantation. Fluconazole prophylaxis reduces both fungal-infection–related and overall mortality
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,
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and has become a standard of care for antifungal prophylaxis after the first 100 days of . . .
Publisher
Massachusetts Medical Society
Subject
/ Adult
/ Aged
/ Antibiotics. Antiinfectious agents. Antiparasitic agents
/ Antifungal Agents - adverse effects
/ Antifungal Agents - therapeutic use
/ Aspergillosis - prevention & control
/ Biological and medical sciences
/ Female
/ Fluconazole - adverse effects
/ Fluconazole - therapeutic use
/ Fungi
/ Graft vs Host Disease - complications
/ Graft vs Host Disease - drug therapy
/ Hematopoietic Stem Cell Transplantation - adverse effects
/ Humans
/ Male
/ Mycoses - prevention & control
/ Opportunistic Infections - prevention & control
