Treatment of invasive candidiasis in neutropenic patients: Systematic review of randomized controlled treatment trials

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

Research output: Contribution to journalReview articlepeer-review

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 favored 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 favor of non-polyene compounds. Across studies, echinocandins provided the benefit of favorable outcomes with fewest side effects and toxicity.

Original languageEnglish (US)
Pages (from-to)1479-1487
Number of pages9
JournalLeukemia and Lymphoma
Volume54
Issue number7
DOIs
StatePublished - Jul 2013

Keywords

  • Amphotericin B
  • Candidiasis
  • Echinocandin
  • Invasive
  • Neutropenia

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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