Controlling the Troll
Authors: Stephen Dummer
Journal: Annals of Internal Medicine (2006)

Letters21 March 2006Controlling the TrollStephen Dummer, MDStephen Dummer, MDFrom Vanderbilt University School of Medicine, Nashville, TN 37232.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-144-6-200603210-00027 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Kalil and colleagues' meta-analysis of CMV management trials (1) is an important contribution to the literature that should be widely cited. The goal of my editorial was not to rephrase or critique their article, which can stand on its own merits. Rather, I hoped to communicate some historical perspective on the topic and discuss the current controversy between prophylactic and preemptive approaches to the management of CMV infection.One concern I had was that some readers might see CMV prophylaxis as the better overall strategy, because the meta-analysis found more benefits for this management strategy than for preemptive ...References1. Kalil AC, Levitsky J, Lyden E, Stoner J, Freifeld AG. Meta-analysis: the efficacy of strategies to prevent organ disease by cytomegalovirus in solid organ transplant recipients. Ann Intern Med. 2005;143:870-80. [PMID: 16365468] LinkGoogle Scholar2. Hibberd PL, Tolkoff-Rubin NE, Conti D, Stuart F, Thistlethwaite JR, Neylan JF, et al. Preemptive ganciclovir therapy to prevent cytomegalovirus disease in cytomegalovirus antibody-positive renal transplant recipients. A randomized, controlled trial. Ann Intern Med. 1995;123:18-26. [PMID: 7762909] LinkGoogle Scholar3. Cole NL, Balfour HH. In vitro susceptibility of cytomegalovirus isolates from immunocompromised patients to acyclovir and ganciclovir. Diagn Microbiol Infect Dis. 1987;6:255-61. [PMID: 3032503] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Vanderbilt University School of Medicine, Nashville, TN 37232.Disclosures: Consultancies: Roche Labs; Honoraria: Roche Labs. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoPreemptive Ganciclovir Therapy To Prevent Cytomegalovirus Disease in Cytomegalovirus Antibody-Positive Renal Transplant Recipients Patricia L. Hibberd , Nina E. Tolkoff-Rubin , David Conti , Frank Stuart , J. Richard Thistlethwaite , John F. Neylan , David R. Snydman , Richard Freeman , Marc I. Lorber , and Robert H. Rubin Controlling the Troll: Management of Cytomegalovirus Infection after Transplantation Stephen Dummer Meta-Analysis: The Efficacy of Strategies To Prevent Organ Disease by Cytomegalovirus in Solid Organ Transplant Recipients Andre C. Kalil , Josh Levitsky , Elizabeth Lyden , Julie Stoner , and Alison G. Freifeld Controlling the Troll Andre C. Kalil , Elizabeth Lyden , and Julie Stoner Metrics 21 March 2006Volume 144, Issue 6Page: 458KeywordsConflicts of interestCytomegalovirus infectionExercisePopulation statisticsProphylaxis ePublished: 21 March 2006 Issue Published: 21 March 2006 Copyright & PermissionsCopyright © 2006 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...