Itraconazole for Antifungal Prophylaxis in Neutropenic Patients: a Meta-Analysis of 2181 Patients

A. GLASMACHER1, C. HAHN1, E. MOLITOR2, G. MARKLEIN2, I. SCHMIDT-WOLF1

Author address: 

1Dpt. of Internal Medicine I, Univ. of Bonn, Bonn, Germany, 2Inst. of Med. Microbiology and Immunology, Univ. of Bonn, Bonn, Germany.

Abstract: 

Background. Although several randomized studies have been performed, the efficacy of itraconazole prophylaxis is not established. Therefore, a systematic review of the available data is warranted. Methods. Randomized, controlled studies with itraconazole for antifungal prophylaxis in neutropenic patients were identified through Medline, the Cochrane database and reference lists. The statistical analysis used the relative risk (RR, 95%-confidence intervals) and a fixed effects model. The primary endpoint was the incidence of proven invasive fungal infections (IFI, not disseminated sinonasal infections excluded). The criteria for proven IFI were adapted to conform with the EORTC/MSG consensus where possible. Results. Seven studies with 2181 patients/episodes were included. The relative risk for a proven IFI was reduced to RR=0.55 (0.35-0.87) in the itraconazole arm (P=0.01). The mortality from IFI was not significantly reduced in total (RR=0.69; 0.38-1.25; P=0.2), but differed in studies using itraconazole capsules (RR=1.38; 0.65-2.93; P=0.4) from studies using itraconazole oral solution (RR=0.17; 0.05-0.66; P=0.01). The overall mortality was not significantly changed (RR=0.82; 0.60-1.12; P=0.2). Two studies reported a higher incidence of hypokalemia in the itraconazole arm (RR=2.05; 1.47-2.87; P
2001

abstract No: 

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Full conference title: 

ICAAC 41st
    • ICAAC 41st