Cornely, O.A., Ullmann, A.J., & Karthaus, M. (2003). Evidence-based assessment of primary antifungal prophylaxis in patients with hematologic malignancies. Blood, 101, 3365–3372.
DOI Link
Purpose
Primary antifungal prophylaxis with fluconazole, itraconazole, or an amphotericin B product were evaluated in neutropenic patients with hematologic malignancies.
Search Strategy
Not described.
Literature Evaluated
Thirty-eight randomized, controlled trials of primary antifungal prophylaxis and 13 historically controlled or uncontrolled trials of primary antifungal prophylaxis.
Sample Characteristics
More than 9,000 neutropenic patients with hematologic malignancies.
Nursing Implications
Recommended antifungal prophylactic regimens for patients with hematologic malignancies and their level of evidence:
Conventional chemotherapy
- Fluconazole 50–400 mg every day by mouth (CI)
- Itraconazole oral suspension 5 mg/kg every day (BI)
- Amphotericin B desoxycholate 1.0 mg/kg every 48 hour by IV (CII)
- Amphotericin B desoxycholate 20 mg inhalation (CI)
Allogeneic transplantation
- Fluconazole 400 mg every day by mouth (AI)
- Fluconazole 50–200 mg every day by mouth (CI)
- Liposomal amphotericin B 1.0 mg/kg every day by IV (CI)