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.
To evaluate the efficacy of fluconazole prophylaxis during chemotherapy-induced neutropenia.
Databases searched were MEDLINE, CancerLit, and the Pfizer company database through April 1999 (no start date was provided). The search was not restricted to the English language or published trials.
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.