Treatment of Invasive Candidiasis in Neutropenic Patients: Systematic Review of Randomized Controlled Treatment Trials, Leukemia & Lymphoma, Informa Healthcare

Treatment of Invasive Candidiasis in Neutropenic Patients: Systematic Review of Randomized Controlled Treatment Trials

Posted online on November 1, 2012. (doi:10.3109/10428194.2012.745073)

Jamil N. Kanji, Michel Laverdière, Coleman Rotstein, Thomas J. Walsh, Prakesh S. Shah and Shariq Haider

Corresponding Author: Shariq Haider, MD, FRCPC, Room M504, Juravinski Hospital and Cancer Center, 711 Concession Street, Hamilton, Ontario L8N 3Z5, Canada. Phone – (905) 521-2100, extension 43251. Fax – (905) 389-0108. Email: haider@mcmaster.ca

ABSTRACT

Candidemia and invasive candidiasis (CIC) is associated with considerable morbidity and mortality with a paucity of controlled data in neutropenic patients. A systematic review was conducted of available data for the treatment of CIC during neutropenia. A structured OVID search of multiple databases was performed. Data from randomized controlled trials of CIC and of empirical antifungal therapy in febrile neutropenic patients was included. A total of 17 trials randomizing 342 neutropenic patients were included. Eight of the studies compared amphotericin B (AmB) to other non-polyene antifungal agents. Pooling of results favoured use of comparator compounds (odds ratio (OR) 0.73; 95% confidence interval (CI) 0.42-1.29). To strengthen our analysis, a pre-planned sensitivity analysis was also conducted. Overall, there was a non-significant benefit in favour of non-polyene compounds. Across studies, echinocandins provided the benefit of favourable outcomes with fewest side effects and toxicity.

Keywords

Candidiasis, invasive, amphotericin B, echinocandin, neutropenia

vía Treatment of Invasive Candidiasis in Neutropenic Patients: Systematic Review of Randomized Controlled Treatment Trials, Leukemia & Lymphoma, Informa Healthcare.

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