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Latest & greatest articles for fluconazole
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Fluconazole prophylaxis in critically ill surgical patients: a meta-analysis Fluconazole prophylaxis in critically ill surgical patients: a meta-analysis Fluconazole prophylaxis in critically ill surgical patients: a meta-analysis Shorr A F, Chung K, Jackson W L, Waterman P E, Kollef M H CRD summary This review evaluated the effects of fluconazole prophylaxis on fungal infections and mortality in critically ill surgical patients. The authors concluded that prophylactic fluconazole appeared (...) to reduce fungal infections but had no effect on mortality, and that further research is required. Overall, this was a reasonably well-conducted review and the authors' cautious conclusions are likely to be reliable. Authors' objectives To evaluate the effects of fluconazole prophylaxis on fungal infections and mortality in critically ill surgical patients. Searching MEDLINE (1966 to December 2004), EMBASE (1990 to December 2004) and the Cochrane Library were searched using the reported search terms
Maintenance fluconazole therapy for recurrent vulvovaginal candidiasis. No safe and convenient regimen has proved to be effective for the management of recurrent vulvovaginal candidiasis.After inducing clinical remission with open-label fluconazole given in three 150-mg doses at 72-hour intervals, we randomly assigned 387 women with recurrent vulvovaginal candidiasis to receive treatment with fluconazole (150 mg) or placebo weekly for six months, followed by six months of observation without (...) therapy. The primary outcome measure was the proportion of women in clinical remission at the end of the first six-month period. Secondary efficacy measures were the clinical outcome at 12 months, vaginal mycologic status, and time to recurrence on the basis of Kaplan-Meier analysis.Weekly treatment with fluconazole was effective in preventing symptomatic vulvovaginal candidiasis. The proportions of women who remained disease-free at 6, 9, and 12 months in the fluconazole group were 90.8 percent, 73.2
Fluconazole for the treatment of cutaneous leishmaniasis caused by Leishmania major. Whereas certain oral antifungal azoles are well documented to have activity against leishmania, data on the efficacy of fluconazole for leishmaniasis are limited. We conducted a controlled trial in Saudi Arabia of fluconazole for the treatment of cutaneous leishmaniasis caused by Leishmania major.This randomized, double-blind, placebo-controlled trial assessed the efficacy of oral fluconazole, in a dose of 200 (...) mg daily for six weeks, in the treatment of parasitologically confirmed cutaneous leishmaniasis. The primary outcome measure was the time to the complete healing of all lesions.A total of 106 patients were assigned to receive fluconazole, and 103 patients were assigned to receive placebo. Follow-up data were available for 80 and 65 patients, respectively. At the three-month follow-up, healing of lesions was complete for 63 of the 80 patients in the fluconazole group (79 percent) and 22 of the 65
Fluconazole prophylaxis against fungal colonization and infection in preterm infants. Invasive fungal infection is associated with substantial morbidity and mortality in preterm infants. We evaluated the efficacy of prophylactic fluconazole in preventing fungal colonization and invasive infection in extremely-low-birth-weight infants.We conducted a prospective, randomized, double-blind clinical trial over a 30-month period in 100 preterm infants with birth weights of less than 1000 g (...) . The infants were randomly assigned during the first five days of life to receive either intravenous fluconazole or placebo for six weeks. We obtained weekly surveillance cultures from all patients.The 50 infants randomly assigned to fluconazole and the 50 control infants were similar in terms of birth weight, gestational age at birth, and base-line risk factors for fungal infection. During the six-week treatment period, fungal colonization was documented in 30 infants in the placebo group (60 percent
Fluconazole vs. amphotericin B for the management of candidaemia in adults: a meta-analysis Fluconazole vs. amphotericin B for the management of candidaemia in adults: a meta-analysis Fluconazole vs. amphotericin B for the management of candidaemia in adults: a meta-analysis Kontoyiannis D P, Bodey G P, Mantzoros C S Authors' objectives To answer two questions. 1. In candidaemic adult patients, does therapy with fluconazole differ from amphotericin B in terms of total mortality, infection (...) -specific mortality, response, late complications, and toxicity? 2. How do the two drugs compare in the treatment of candidaemia caused by various non-albicans Candida species? Searching MEDLINE was searched from January 1966 to May 1999 using the MeSH terms 'candidaemia', 'candidiasis', 'fluconazole', 'amphotericin B', 'antifungal therapy' and 'prospective studies'. The search was restricted to studies published in the English language. References, review articles and abstracts from international
Impact of an intravenous fluconazole restriction policy on patient outcomes Impact of an intravenous fluconazole restriction policy on patient outcomes Impact of an intravenous fluconazole restriction policy on patient outcomes Burkiewicz J S, Kostiuk K A, Jacobs R A, Guglielmo B J Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed (...) by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology A prescription guideline to substitute the use of intravenous fluconazole with oral fluconazole, in the treatment of patients with moderate to severe infections. Type of intervention Prescribing guideline. Economic study type Cost-effectiveness analysis (cost-consequences). Study population The study population comprised adult and paediatric patients in a university teaching hospital, who were
Amphotericin B vs fluconazole for controlling fungal infections in neutropenic cancer patients. Systemic fungal infection is considered to be an important cause of morbidity and mortality in cancer patients, particularly those with neutropenia. Antifungal drugs are often given prophylactically, or to patients with persistent fever.To compare the effect of fluconazole and amphotericin B on morbidity and mortality in patients with cancer complicated by neutropenia.MEDLINE and Cochrane Library (...) (March 2000). Letters, abstracts, and unpublished trials. The industry and authors were contacted.Randomised trials comparing fluconazole with amphotericin B.Data on mortality, invasive fungal infection, colonisation, use of additional (escape) antifungal therapy and adverse effects leading to discontinuation of therapy were extracted by both authors independently.Thirteen trials (2977 patients) were included. In 3 large 3-armed trials, which comprised 43% of the patients, results for amphotericin B
Prophylactic action of oral fluconazole against fungal infection in neutropenic patients: a meta-analysis of 16 randomized, controlled trials Prophylactic action of oral fluconazole against fungal infection in neutropenic patients: a meta-analysis of 16 randomized, controlled trials Prophylactic action of oral fluconazole against fungal infection in neutropenic patients: a meta-analysis of 16 randomized, controlled trials Kanda Y, Yamamoto R, Chizuka A, Hamaki T, Suguro M, Arai C, Matsuyama T (...) , Takezako N, Miwa A, Kern W, Kami M, Akiyama H, Hirai H, Togawa A Authors' objectives To assess the efficacy of fluconazole prophylaxis during chemotherapy-induced neutropenia. Searching MEDLINE, Cancerlit and a company database (Pfizer) were searched; the last search was performed in April 1999. No details were given of the keywords used. Studies reported in any language were considered, and both published and unpublished studies were eligible. Study selection Study designs of evaluations included
Economic analysis of fluconazole versus amphotericin B for the treatment of candidemia in non-neutropenic patients Economic analysis of fluconazole versus amphotericin B for the treatment of candidemia in non-neutropenic patients Economic analysis of fluconazole versus amphotericin B for the treatment of candidemia in non-neutropenic patients Dranitsaris G, Phillips P, Rotstein C, Puodziunas A, Shafran S, Garber G, Smaill F, Salit I, Miller M, Williams K, Conly J, Singer J, Ioannou S Record (...) Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology Treatment of candidemia using two intravenous antifungal therapies, either fluconazole (FLU) or amphotericin B(AMB). Type of intervention Treatment. Economic study type Cost-effectiveness
Fluconazole as prophylaxis against fungal infection in patients with advanced HIV infection Fluconazole as prophylaxis against fungal infection in patients with advanced HIV infection Fluconazole as prophylaxis against fungal infection in patients with advanced HIV infection Manfredi R, Mastroianni A, Coronado O V, Chiodo F Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract contains a brief summary of the methods (...) , the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology Fluconazole treatment for the prevention of systemic fungal diseases related to the AIDS. Type of intervention Primary prevention and treatment. Economic study type Cost-effectiveness analysis. Study population HIV-infected subjects with advanced infection and a CD4+ lymphocyte count below 0.20x 10?9 Setting Hospital. The economic study was carried out
Fluconazole compared with endoscopy for human immunodeficiency virus-infected patients with esophageal symptoms Fluconazole compared with endoscopy for human immunodeficiency virus-infected patients with esophageal symptoms Fluconazole compared with endoscopy for human immunodeficiency virus-infected patients with esophageal symptoms Wilcox C M, Alexander L N, Clark W S, Thompson S E Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS (...) EED. Each abstract contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. Health technology Fluconazole compared with endoscopy for Human Immunodeficiency Virus (HIV)-infected patients. Type of intervention Treatment. Economic study type Cost-effectiveness analysis. Study population HIV-infected patients with esophageal symptoms. No further details were given. Setting Hospital
A randomized trial comparing fluconazole with clotrimazole troches for the prevention of fungal infections in patients with advanced human immunodeficiency virus infection. NIAID AIDS Clinical Trials Group. Cryptococcal meningitis and other serious fungal infections are common complications in patients infected with the human immunodeficiency virus (HIV). Fluconazole is effective for long-term suppression of many fungal infections, but its effectiveness as primary prophylaxis had not been (...) adequately evaluated.We conducted a prospective, randomized trial that compared fluconazole (200 mg per day) with clotrimazole troches (10 mg taken five times daily) in patients who were also participating in a randomized trial of primary prophylaxis for Pneumocystis carinii pneumonia.After a median follow-up of 35 months, invasive fungal infections had developed in 4.1 percent of the patients in the fluconazole group (9 of 217) and in 10.9 percent of those in the clotrimazole group (23 of 211; relative
A randomized trial comparing fluconazole with amphotericin B for the treatment of candidemia in patients without neutropenia. Candidemia Study Group and the National Institute. Amphotericin B has long been the standard treatment for candidemia, but its use is complicated by its toxicity. More recently, fluconazole, a water-soluble triazole with activity against candida species and little toxicity, has become available. We conducted a multicenter randomized trial that compared amphotericin B (...) with fluconazole as treatment for candidemia.To be eligible, patients had to have a positive blood culture for candida species, a neutrophil count > or = 500 per cubic millimeter, and no major immunodeficiency. Patients were randomly assigned to receive either amphotericin B (0.5 to 0.6 mg per kilogram of body weight per day) or fluconazole (400 mg per day), each continued for at least 14 days after the last positive blood culture. Outcomes were assessed by a group of investigators blinded to treatment
Comparison of amphotericin B with fluconazole in the treatment of acute AIDS-associated cryptococcal meningitis. The NIAID Mycoses Study Group and the AIDS Clinical Trials Group. Intravenous amphotericin B, with or without flucytosine, is usually standard therapy for cryptococcal meningitis in patients with the acquired immunodeficiency syndrome (AIDS). Fluconazole, an oral triazole agent, represents a promising new approach to the treatment of cryptococcal disease.In a randomized multicenter (...) trial, we compared intravenous amphotericin B with oral fluconazole as primary therapy for AIDS-associated acute cryptococcal meningitis. Eligible patients, in all of whom the diagnosis had been confirmed by culture, were randomly assigned in a 2:1 ratio to receive either fluconazole (200 mg per day) or amphotericin B. Treatment was considered successful if the patient had had two consecutive negative cerebrospinal fluid cultures by the end of the 10-week treatment period.Of the 194 eligible
A controlled trial of fluconazole or amphotericin B to prevent relapse of cryptococcal meningitis in patients with the acquired immunodeficiency syndrome. The NIAID AIDS Clinical Trials Group and Mycoses Study Group. After primary treatment for cryptococcal meningitis, patients with the acquired immunodeficiency syndrome (AIDS) require some form of continued suppressive therapy to prevent relapse.We conducted a multicenter, randomized trial that compared fluconazole (200 mg per day given orally (...) to fluconazole and 99 to amphotericin B. Twenty-three patients were found not to have met the entry criteria; six other patients assigned to amphotericin B did not receive it and were lost to follow-up. Of the remaining 189 patients, after a median follow-up of 286 days 14 of 78 receiving amphotericin B (18 percent) and 2 of 111 assigned to fluconazole (2 percent) had relapses of symptomatic cryptococcal disease (P less than 0.001 by Fisher's exact test). There was a difference of 19 percent in the estimated
A controlled trial of fluconazole to prevent fungal infections in patients undergoing bone marrow transplantation. Superficial and systemic fungal infections are a major problem among severely immunocompromised patients who undergo bone marrow transplantation. We performed a double-blind, randomized, multicenter trial in which patients receiving bone marrow transplants were randomly assigned to receive placebo or fluconazole (400 mg daily). Fluconazole or placebo was administered (...) prophylactically from the start of the conditioning regimen until the neutrophil count returned to 1000 per microliter, toxicity was suspected, or a systemic fungal infection was suspected or proved.By the end of the treatment period, 67.2 percent of the 177 patients assigned to placebo had a positive fungal culture of specimens from any site, as compared with 29.6 percent of the 179 patients assigned to fluconazole. Among these, superficial infections were diagnosed in 33.3 percent of the patients receiving
Increased gastric pH and the bioavailability of fluconazole and ketoconazole. 2012358 1991 05 07 2013 11 21 0003-4819 114 9 1991 May 01 Annals of internal medicine Ann. Intern. Med. Increased gastric pH and the bioavailability of fluconazole and ketoconazole. 755-7 Blum R A RA Millard Fillmore Hospital, Buffalo, New York. D'Andrea D T DT Florentino B M BM Wilton J H JH Hilligoss D M DM Gardner M J MJ Henry E B EB Goldstein H H Schentag J J JJ eng Clinical Trial Journal Article Randomized (...) Controlled Trial Research Support, Non-U.S. Gov't United States Ann Intern Med 0372351 0003-4819 80061L1WGD Cimetidine 8VZV102JFY Fluconazole R9400W927I Ketoconazole AIM IM Adult Biological Availability Cimetidine pharmacology Drug Interactions Fluconazole pharmacokinetics Gastric Acidity Determination Humans Ketoconazole pharmacokinetics Male Random Allocation Statistics as Topic 1991 5 1 1991 5 1 0 1 1991 5 1 0 0 ppublish 2012358
A placebo-controlled trial of maintenance therapy with fluconazole after treatment of cryptococcal meningitis in the acquired immunodeficiency syndrome. California Collaborative Treatment Group. In patients with the acquired immunodeficiency syndrome (AIDS), the rate of relapse after primary treatment for cryptococcal meningitis remains high. We conducted a controlled, double-blind trial to evaluate the efficacy of maintenance therapy with fluconazole. At entry into the study, all participants (...) had sterile cultures of cerebrospinal fluid, blood, and urine after following a standardized course of therapy for culture-proved cryptococcal meningitis. The patients were randomly assigned to take either fluconazole or placebo as maintenance therapy. The dose of fluconazole was 100 mg daily in the first phase of study and 200 mg daily in the second phase.Of 84 patients initially enrolled, 16 (19 percent) were found to have silent, persistent infection on the basis of cultures that became
Comparison of fluconazole and ketoconazole for oropharyngeal candidiasis in AIDS. In a randomised, double-blind study the efficacy and toxicity of oral fluconazole 50 mg daily and ketoconazole 200 mg daily were compared for the treatment of oropharyngeal candidiasis in patients with acquired immunodeficiency syndrome (AIDS) and AIDS-related complex (ARC). 20 episodes (18 patients) were treated with fluconazole and 20 episodes (19 patients) with ketoconazole. Pretreatment clinical features (...) and laboratory test results were similar in both groups. 17 episodes (85%) in the fluconazole group and 16 (80%) in the ketoconazole group could be evaluated. There was clinical cure at the end of therapy in all fluconazole-treated and 12 of 16 (75%) ketoconazole-treated episodes. Cultures were negative at the end of therapy in 87% of the fluconazole group and 69% of the ketoconazole group. 1 patients stopped taking fluconazole because of severe nausea. 1 of 18 fluconazole-treated and 4 of 19 ketoconazole