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Micafungin versus fluconazole for prophylaxis against invasive fungal infections during neutropenia in patients undergoing hematopoietic stem cell transplantation.
- Source :
-
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America [Clin Infect Dis] 2004 Nov 15; Vol. 39 (10), pp. 1407-16. Date of Electronic Publication: 2004 Oct 27. - Publication Year :
- 2004
-
Abstract
- We hypothesized that chemoprophylaxis with the echinocandin micafungin would be an effective agent for antifungal prophylaxis during neutropenia in patients undergoing hematopoietic stem cell transplantation (HSCT). We therefore conducted a randomized, double-blind, multi-institutional, comparative phase III trial, involving 882 adult and pediatric patients, of 50 mg of micafungin (1 mg/kg for patients weighing <50 kg) and 400 mg of fluconazole (8 mg/kg for patients weighing <50 kg) administered once per day. Success was defined as the absence of suspected, proven, or probable invasive fungal infection (IFI) through the end of therapy and as the absence of proven or probable IFI through the end of the 4-week period after treatment. The overall efficacy of micafungin was superior to that of fluconazole as antifungal prophylaxis during the neutropenic phase after HSCT (80.0% in the micafungin arm vs. 73.5% in the fluconazole arm [difference, 6.5%]; 95% confidence interval, 0.9%-12%; P=.03). This randomized trial demonstrates the efficacy of an echinocandin for antifungal prophylaxis in neutropenic patients.
- Subjects :
- Adolescent
Adult
Aged
Child
Child, Preschool
Double-Blind Method
Echinocandins
Female
Humans
Infant
Lipopeptides
Male
Micafungin
Middle Aged
Fluconazole therapeutic use
Hematopoietic Stem Cell Transplantation adverse effects
Lipoproteins therapeutic use
Mycoses etiology
Mycoses prevention & control
Neutropenia complications
Peptides, Cyclic therapeutic use
Subjects
Details
- Language :
- English
- ISSN :
- 1537-6591
- Volume :
- 39
- Issue :
- 10
- Database :
- MEDLINE
- Journal :
- Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
- Publication Type :
- Academic Journal
- Accession number :
- 15546073
- Full Text :
- https://doi.org/10.1086/422312