Prophylactic action of oral fluconazole against fungal infection in neutropenic patients

Kanda, Yoshinobu; Yamamoto, Rie; Chizuka, Aki; Hamaki, Tamae; Suguro, Miyuki; Arai, Chiaki; Matsuyama, Tomohiro; Takezako, Naoki; Miwa, Akiyoshi; Kern, Wolfgang; Kami, Masahiro; Akiyama, Hideki; Hirai, Hisamaru; Togawa, Atsushi

doi:10.1002/1097-0142(20001001)89:7<1611::aid-cncr27>3.3.co;2-2

Cited by 56 publications

(86 citation statements)

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“…Although many studies have strongly recommended highdose (400 mg/day) fluconazole prophylaxis, [23][24][25] there are also several studies that have used lower dose (50-200 mg/ day). [26][27][28][29][30] The predominance of mold form and few yeast infections despite low-dose fluconazole prophylaxis at our Table 4 Causes of death during three recovery phases after transplant Infection after allogeneic HSCT in Korea J-H Yoo et al institution was not clearly explainable. This should be elucidated further in the future study.…”

Section: Discussionmentioning

confidence: 79%

Infectious complications and outcomes after allogeneic hematopoietic stem cell transplantation in Korea

Lee

Choi

et al. 2004

Bone Marrow Transplant

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Summary:We reviewed 242 allogeneic hematopoietic stem cell transplantation (HSCT) recipients retrospectively over a 2-year period (January 1998-December 1999 in order to analyze the characteristics and assess the outcomes of infectious complications in patients after HSCT in Korea. Bacteria were the major pathogens before engraftment, and viral and fungal infections predominated during the post-engraftment period. Varicella zoster virus was the most common viral pathogen after engraftment. Cytomegalovirus disease occurred mainly in the late-recovery phase. The frequency of mold infection was higher than that of yeast. There was a relatively high incidence of tuberculosis (3.0%) and Pneumocystis carinii pneumonia (6.5%). One case of death by measles confirmed by autopsy was also noted. Overall, cumulative mortality was 43% (104/242), and 59.6% of these deaths (62/104) were infection-related. Allogeneic HSCT recipents from unrelated donors were prone to infectious complication and higher mortality than those from matched sibling (17/39 (43.6%) vs 45/203 (22.2%), respectively; Po0.01; odd ratio 2.5; 95% confidence interval 1.2-5.1). As infection was the main post-HSCT complication in our data, more attention should be given to the management of infections in HSCT recipients.

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Section: Discussionmentioning

confidence: 79%

Infectious complications and outcomes after allogeneic hematopoietic stem cell transplantation in Korea

Lee

Choi

et al. 2004

Bone Marrow Transplant

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“…One patient received it prophylactically as a result of persistent fever beyond day five. A multicenter randomized trial by Winston et al 17 and a meta-analysis of sixteen randomized trials published by Kanda et al 18 …”

Section: Choice Of Antimicrobial Agentmentioning

confidence: 99%

Management of Febrile Neutropenia in Patients receiving Chemotherapy for Solid Tumors: A Retrospective Study of Twenty Cases from the Radiotherapy Centre, Accra, Ghana

Vanderpuye

Yarney²,

Beecham³

2011

West African Journal of Medicine

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“…12,13 Despite the lack of prospective clinical trials comparing different approaches, primary antifungal prophylaxis is widely used in most of the centers for high-risk patients. The prophylactic use of fluconazole has been shown to reduce the incidence of invasive candidiasis and improve survival; 14 however, this agent is not active against the filamentous fungi, Aspergillus, and has therefore led to an increase in the frequency of invasive aspergillosis with extremely high mortality. 2,3,15 The introduction of new and safe antifungal agents has lead to the design of prophylactic prospective controlled trials, [16][17][18] but most published studies include few if any pediatric patients.…”

Section: Introductionmentioning

confidence: 99%

Voriconazole as primary antifungal prophylaxis in children undergoing allo-SCT

Molina

Serrano

Sánchez‐García

et al. 2011

Bone Marrow Transplant

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Invasive fungal disease (IFD) causes significant morbidity and mortality among children undergoing allo-SCT. In this prospective pilot study, we analyze voriconazole as primary antifungal prophylaxis. From October 2004 to July 2010, 56 children o18 years of age were enrolled in this study. Patients received voriconazole doses of 5 mg/ kg per 12 h (n ¼ 23) or 7 mg/kg per 12 h (n ¼ 33), with a limiting dose of 200 mg/12 h, from day À1 to day þ 75 or later in patients with active acute GVHD. Patients were followed up for IFD for 6 months. In this series, 37 (66.1%) patients successfully completed treatment (85.7% during neutropenic period) without empirical or preemptive antifungal therapy, adverse effects or IFD. Nine (16.1%) children needed preemptive (n ¼ 2) or empirical (n ¼ 7) antifungal therapy, and one (1.8%) of them developed a fatal probable IFD during the study period. A total of 10 (17.8%) children developed adverse effects related to voriconazole prophylaxis, leading to definitive withdrawal on median day 26.5 (in 7 patients after granulocytic recovery). The most frequent adverse effect was persistent elevation of hepatic enzymes in seven (12.5%) children. There were no differences between doses of 5 and 7 mg/kg per 12 h. Our results suggest that voriconazole can be safely used as primary antifungal prophylaxis in children undergoing allo-SCT.

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Prophylactic action of oral fluconazole against fungal infection in neutropenic patients

Cited by 56 publications

References 0 publications

Infectious complications and outcomes after allogeneic hematopoietic stem cell transplantation in Korea

Infectious complications and outcomes after allogeneic hematopoietic stem cell transplantation in Korea

Management of Febrile Neutropenia in Patients receiving Chemotherapy for Solid Tumors: A Retrospective Study of Twenty Cases from the Radiotherapy Centre, Accra, Ghana

Voriconazole as primary antifungal prophylaxis in children undergoing allo-SCT

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