Cho, S.Y., Lee, D.G., Choi, S.M., Choi, J.K., Lee, H.J., Kim, S.H., . . . Min, W.S. (2015). Posaconazole for primary antifungal prophylaxis in patients with acute myeloid leukaemia or myelodysplastic syndrome during remission induction chemotherapy: A single-centre retrospective study in Korea and clinical considerations. Mycoses, 58, 565–571.
To examine the incidence and outcomes related to the treatment of invasive fungal infection (IFI) with posaconazole versus fluconazole prophylaxis
Records of patients undergoing remission induction chemotherapy were reviewed for data collection. Results of those who received fluconazole versus posaconazole antifungal prophylaxis were compared. Both agents were begun 1–2 days prior to chemotherapy and continued until the patients' absolute neutrophil count (ANC) was > 500/mm3.
The incidence of breakthrough IFIs and the use of empirical antifungal treatment were lower in those who received posaconazole (p < 0.001). Overall, IFI-related mortality was 1.9% in the posaconazole group compared to 12.1% in the fluconazole group (p = 0.028). No difference existed between groups in overall survival.
The findings suggest that posaconazole was more effective than early generation azoles for antifungal prophylaxis in at-risk patients with cancer.
The findings suggest that newer azoles may be more effective for antifungal prophylaxis in at-risk patients with cancer.