@article{998d3d45882b416ead24c14e67049e0f,
title = "Anidulafungin versus fluconazole for invasive candidiasis",
abstract = "BACKGROUND: Anidulafungin, a new echinocandin, has potent activity against candida species. We compared anidulafungin with fluconazole in a randomized, double-blind, non-inferiority trial of treatment for invasive candidiasis. METHODS: Adults with invasive candidiasis were randomly assigned to receive either intravenous anidulafungin or intravenous fluconazole. All patients could receive oral fluconazole after 10 days of intravenous therapy. The primary efficacy analysis assessed the global response (clinical and microbiologic) at the end of intravenous therapy in patients who had a positive baseline culture. Efficacy was also assessed at other time points. RESULTS: Eighty-nine percent of the 245 patients in the primary analysis had candidemia only. Candida albicans was isolated in 62% of the 245 patients. In vitro fluconazole resistance was infrequent. Most of the patients (97%) did not have neutropenia. At the end of intravenous therapy, treatment was successful in 75.6% of patients treated with anidulafungin, as compared with 60.2% of those treated with fluconazole (difference, 15.4 percentage points; 95% confidence interval [CI], 3.9 to 27.0). The results were similar for other efficacy end points. The statistical analyses failed to show a {"}center effect{"}; when data from the site enrolling the largest number of patients were removed, success rates at the end of intravenous therapy were 73.2% in the anidulafungin group and 61.1% in the fluconazole group (difference, 12.1 percentage points; 95% CI, ?1.1 to 25.3). The frequency and types of adverse events were similar in the two groups. The rate of death from all causes was 31% in the fluconazole group and 23% in the anidulafungin group (P = 0.13). CONCLUSIONS: Anidulafungin was shown to be noninferior to fluconazole in the treatment of invasive candidiasis.",
author = "Reboli, {Annette C.} and Coleman Rotstein and Pappas, {Peter G.} and Chapman, {Stanley W.} and Kett, {Daniel H.} and Deepali Kumar and Robert Betts and Michele Wible and Goldstein, {Beth P.} and Jennifer Schranz and Krause, {David S.} and Walsh, {Thomas J.}",
note = "Funding Information: In addition to the authors, the following investigators were members of the Anidulafungin Study Group: Belgium — E. Van Wijngaerden, Katholieke Universiteit en Universitaire Zieken Huizen Leuven, Herestraat, Leuven; Canada — E. Bow, Cancer Care Manitoba, Winnipeg, MB; G. Garber, Ottawa Hospital General Campus, Ottawa; M. Laverdiere, Hospital Maisonneuve Rosemont, Montreal; M. Libman, Montreal General Hospital, Montreal; R. Pelletier, Hotel-Dieu de Quebec, Quebec, QC; S. Sanche, Royal University Hospital, Saskatoon, SK; Germany — O. Cornely, Klinik I f{\"u}r Innere Medizin, Universit{\"a}tsklinik K{\"o}ln, Cologne; W. Kern, Zentrum Klinische Studien Medizinische Universit{\"a}tsklinik, Freiburg; M. Ruhnke, Med. Klinik und Poliklinik mit Schwerpunkt Haemat, Berlin; Italy — G. Carosi, Brescia City Hospital, Brescia; the Netherlands — P. Verweij, University Medical Center Nijmegen, Nijmegen; United States — E. Anaissie, University of Arkansas for Medical Sciences, Little Rock; M. Bochan, Infectious Disease of Indiana Personal Service Corporation, St. Vincent Hospitals and Health Services, Indianapolis; C. Carpenter, William Beaumont Hospital, Royal Oak, MI; C. Cicogna, Hackensack University Medical Center, Hackensack, NJ; J. Cleary, N. Finley, University of Mississippi Medical Center, Jackson; R. Fetchick, University of Texas Health Science Center, San Antonio; B. Friedman, Research Consortium–Doctors Hospital, Augusta, GA; D. Graham, Springfield Clinic Research, Springfield, IL; R. Graybill, University of Texas Health Science Center, San Antonio; C. Hsiao, Buffalo General Hospital, Buffalo, NY; R. Jones, Reading Hospital and Medical Center, West Reading, PA; T. Kerkering, Brody School of Medicine, Greenville, NC; T. Kurtz, LM Leonard Research Institute, Des Moines, IA; D. McClain, Mission St. Joseph's, Asheville, NC; J. Nowakowski, New York Medical College, Valhalla; L. Ostrosky-Zeichner, University of Texas Health Science Center–Houston Medical School, Houston; J. Perfect, Duke University Medical Center, Durham, NC; J. Pullman, Big Sky Clinical Research, Butte, MT; A. Quartin, Miller School of Medicine at the University of Miami, Miami; J. Reinhardt, Christiana Care Health Services, Newark, DE; B. Segal, Roswell Park Cancer Institute, Buffalo, NY; S. Shahryar, Arizona Pulmonary Specialists, Phoenix; S. Shoham, Washington Hospital Center, Washington, DC; P. Sioson, Jackson–Madison County General Hospital, Jackson, TN; L. Sloan, Baylor University Medical Center, Dallas; J. Solomkin, University of Cincinnati Medical Center, Cincinnati; J. Vazquez, Harper Hospital, Detroit; N. Zapata-Molina, Ponce School of Medicine, Ponce, Puerto Rico. ",
year = "2007",
month = jun,
day = "14",
doi = "10.1056/NEJMoa066906",
language = "English (US)",
volume = "356",
pages = "2472--2482",
journal = "New England Journal of Medicine",
issn = "0028-4793",
publisher = "Massachussetts Medical Society",
number = "24",
}