Itraconazole versus Fluconazole for Antifungal Prophylaxis
Authors: Sherif B. Mossad
Journal: Annals of Internal Medicine (2004)

Letters6 April 2004Itraconazole versus Fluconazole for Antifungal ProphylaxisSherif B. Mossad, MDSherif B. Mossad, MDFrom Cleveland Clinic Foundation, Cleveland, OH 44195.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-140-7-200404060-00028 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Winston and colleagues' data and conclusions (1) should remind us of the problems encountered in the design and reporting of trials of antifungal agents (2). First, it is unclear why blinding of the 2 agents studied was “technologically impossible.” Second, even though a multivariable analysis that included graft-versus-host disease showed that itraconazole was still associated with fewer fungal infections than fluconazole, the randomization process could have easily stratified patients by donor type, related versus unrelated, at enrollment. Third, the authors did not mention what percentage of patients in both groups were treated empirically with amphotericin B for ...References1. Winston DJ, Maziarz RT, Chandrasekar PH, Lazarus HM, Goldman M, Blumer JL, et al . Intravenous and oral itraconazole versus intravenous and oral fluconazole for long-term antifungal prophylaxis in allogeneic hematopoietic stem-cell transplant recipients. A multicenter, randomized trial. Ann Intern Med. 2003;138:705-13. [PMID: 12729424] LinkGoogle Scholar2. Johansen HK, Gotzsche PC. Problems in the design and reporting of trials of antifungal agents encountered during meta-analysis. JAMA. 1999;282:1752-9. [PMID: 10568648] CrossrefMedlineGoogle Scholar3. Gotzsche PC, Johansen HK. Routine versus selective antifungal administration for control of fungal infections in patients with cancer. Cochrane Database Syst Rev. 2002;:CD000026. [PMID: 12076377] MedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Sherif B. Mossad, MDAffiliations: From Cleveland Clinic Foundation, Cleveland, OH 44195. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoIntravenous and Oral Itraconazole versus Intravenous and Oral Fluconazole for Long-Term Antifungal Prophylaxis in Allogeneic Hematopoietic Stem-Cell Transplant Recipients: A Multicenter, Randomized Trial Drew J. Winston , Richard T. Maziarz , Pranatharthi H. Chandrasekar , Hillard M. Lazarus , Mitchell Goldman , Jeffrey L. Blumer , Gerhard J. Leitz , and Mary C. Territo Itraconazole versus Fluconazole for Antifungal Prophylaxis Drew J. Winston , Richard T. Maziarz , and Pranatharthi H. Chandrasekar Itraconazole versus Fluconazole for Antifungal Prophylaxis Meinolf Karthaus , Oliver A. Cornely , and Andrew J. Ullmann Itraconazole versus Fluconazole for Antifungal Prophylaxis John H. Powers and Karen M. Higgins Metrics 6 April 2004Volume 140, Issue 7Page: 580-581KeywordsAbsolute risk reductionAntifungalsAspergillosisChemoradiation therapyFungal diseasesInfectious diseasesMortalityProphylaxisSteroidsTransplantation ePublished: 6 April 2004 Issue Published: 6 April 2004 Copyright & PermissionsCopyright © 2004 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...