Itraconazole versus amphotericin B plus nystatin in the prophylaxis of fungal infections in neutropenic cancer patients

• Published in: Journal of antimicrobial chemotherapy 2001-07, Vol.48 (1), p.97-103
• Main Authors: Boogaerts, Marc, Maertens, Johan, van Hoof, Achiel, de Bock, Robrecht, Fillet, Georges, Peetermans, Marc, Selleslag, Dominik, Vandercam, Bernard, Vandewoude, Koenraad, Zachée, Pierre, De Beule, Karel
• Format: Article
• Language: English
• Subjects: Adult; Aged; Amphotericin B - administration & dosage; Amphotericin B - adverse effects; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antifungal agents; Antifungal Agents - therapeutic use; Biological and medical sciences; Female; Humans; Itraconazole - adverse effects; Itraconazole - blood; Itraconazole - therapeutic use; Male; Medical sciences; Middle Aged; Mycoses - prevention & control; Neoplasms - complications; Neutropenia - complications; Nystatin - administration & dosage; Pharmacology. Drug treatments
• ISSN: 0305-7453; 1460-2091; 1460-2091
• DOI: 10.1093/jac/48.1.97

The efficacy and safety of itraconazole oral solution and a combination of amphotericin B capsules plus nystatin oral suspension were compared in the prophylaxis of fungal infections in neutropenic patients. In an open, randomized, multicentre trial, 144 patients received itraconazole oral solution 100 mg bd, and 133 patients received amphotericin B 500 mg tds plus nystatin 2 MU qds. Overall, 65% of itraconazole-treated patients were considered to have had successful prophylaxis, compared with 53% in the polyene group. Proven deep fungal infections occurred in 5% of patients in each group. Fewer patients receiving itraconazole than amphotericin plus nystatin had superficial infections (3 versus 8%; P = 0.066). This trend in favour of itraconazole was seen in patients with profound neutropenia (neutrophil count