Itraconazole versus Fluconazole for Antifungal Prophylaxis
Authors: John H. Powers, Karen M. Higgins
Journal: Annals of Internal Medicine (2004)

Letters6 April 2004Itraconazole versus Fluconazole for Antifungal ProphylaxisJohn H. Powers, MD and Karen M. Higgins, ScDJohn H. Powers, MDFrom U.S. Food and Drug Administration, Rockville, MD 20850.Search for more papers by this author and Karen M. Higgins, ScDFrom U.S. Food and Drug Administration, Rockville, MD 20850.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-140-7-200404060-00027 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Winston and colleagues (1) showed that studying a relatively small sample of high-risk patients may allow demonstration of a potential difference between prophylactic drugs. However, the results of their study may not be generalizable to patients receiving allogeneic hematopoietic stem-cell transplantation in other institutions with a lower rate of fungal infections. The rate of fungal infections with fluconazole was 2.4% in a recent trial of prophylaxis in allogeneic transplant recipients (2) compared with 25% in Winston and colleagues' trial.This trial considered empirically treated patients and those who died as “successes.” Current diagnostic tests are not sensitive ...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. Van Burik J, Ratanatharathorn V, Lipton J, Miller C, Bunin N, Walsh T. Randomized, double blind trial of micafungin versus fluconazole for prophylaxis of invasive fungal infections in patients undergoing hematopoietic stem cell transplant [Abstract]. Presented at 42nd Interscience Conference on Antimicrobial Agents and Chemotherapy, San Diego, California, 27–30 September 2002. Abstract no. M-1238. Google Scholar3. Bodey GP. Fungal infections complicating acute leukemia. J Chronic Dis. 1966;19:667-87. [PMID: 5229422] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: John H. Powers, MD; Karen M. Higgins, ScDAffiliations: From U.S. Food and Drug Administration, Rockville, MD 20850.Disclaimer The opinions expressed in this letter are those of the authors and not necessarily those of the U.S. Food and Drug Administration. 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 Sherif B. Mossad 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 Metrics Cited bySalvage Therapy Trials in Invasive Fungal Disease: Challenges and OpportunitiesReporting of Deaths During Pre-Approval Clinical Trials for Advanced HIV-Infected Populations 6 April 2004Volume 140, Issue 7Page: 580KeywordsAdverse reactionsAntifungalsAutopsyDrugsFood and Drug AdministrationFungal diseasesMortalityProphylaxisTransplantation ePublished: 6 April 2004 Issue Published: 6 April 2004 Copyright & PermissionsCopyright © 2004 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...