Kanda, Y., Yamamoto, R., Chizuka, A., Hamaki, T., Suguro, M., Arai, C., . . . Togawa, A. (2000). Prophylactic action of oral fluconazole against fungal infection in neutropenic patients. A meta-analysis of 16 randomized, controlled trials. Cancer, 89, 1611–1625.doi:10.1002/1097-0142(20001001)89:7<1611::AID-CNCR27>3.0.CO;2-B
To evaluate the efficacy of fluconazole prophylaxis during chemotherapy-induced neutropenia.
Sixteen trials were evaluated.
Studies were included if they
Data from the meta-analyses reported the combined population, bone marrow transplant (BMT) recipients only, and non-BMT recipients only.
A total of 3,734 patients were evaluated. Some studies exclusively examined BMT recipients, others studied non-BMT recipients, and others evaluated a combined population.
Prophylactic fluconazole was not effective in
Prophylactic fluconazole was effective in
Prophylactic fluconazole did not increase rates of proven systemic infection with resistant strains in the non-BMT or BMT populations.
Colonization of fluconazole-resistant fungi increased with prophylactic treatment in BMT recipients; however, information about non-BMT recipients is inconclusive because of lack of power and paucity of data.