In previous trials, fluconazole (FLU) was more effective than placebo in preventing fungal infections in liver transplant recipients. Thus, in this study, liver transplant patients were randomized to receive antifungal prophylaxis with either oral itraconazole (ITRA) solution (200 mg po q12h) or intravenous/oral FLU (400mg IV/po q24h) from time of transplant until 10 weeks after transplant. There were 90 ITRA patients and 84 FLU patients. Proven fungal infections occurred in 8/90 (8.9%) ITRA patients and 3/84 (3.6%) FLU patients. Respective incidences of proven superficial and proven invasive fungal infections were 2/90 (2.2%) and 6/90(6.7%) in the ITRA group and 1/84 (1.2%) and 2/84 (2.4%) in the FLU group. Organisms causing infections were Candida glabrata (4), Candida albicans (2), and Aspergillus sp(2) in the ITRA group and Candida glabrata (1), Candida krusei (1) and Aspergillus sp(1) in the FLU group. Both ITRA and FLU were generally well tolerated. Gastrointestinal side effects (nausea, vomiting, diarrhea) were more frequent with ITRA. No ITRA or FLU patients were removed from the study due to hepatotoxicity. These results suggest that ITRA and FLU may have similar efficacy for prevention of fungal infections after liver transplantation.
Full conference title:
22nd International Congress of Chemotherapy (ICC)
- ICC 22nd