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Oral ketoconazole prophylaxis for Candida infections during induction therapy for acute leukaemia in adults: more bacteraemias.

Abstract：

:We determined whether ketoconazole prophylaxis might reduce Candida colonization and infections in adult patients with acute leukaemia. During first-remission induction therapy 50 patients were treated with 200 mg ketoconazole administered orally daily, while 57 patients received placebo in a double-blind, randomized trial. The duration of severe neutropenia (granulocytes less than 0.1 x 10(9) l-1) represented 36% of the study period in the ketoconazole group and 26% in the placebo group (P = 0.043). Although fewer patients presented with positive Candida surveillance cultures and serological evidence of Candida infection in the ketoconazole group compared to the placebo group, two candidaemias and one Trichosporum fungaemia were observed in the ketoconazole group. Moreover, significantly more bacteraemias were noted in the ketoconazole group (n = 37) than in the placebo group (n = 21) (P = 0.004). Thus, although oral ketoconazole prophylaxis might be associated with less Candida colonization and fewer seroconversions, it also resulted in more bacteraemias and longer duration of severe neutropenia, suggesting that caution should be exercised when ketoconazole (or related drugs) is given to this group of immunocompromised hosts.

journal_name

J Intern Med

journal_title

Journal of internal medicine

authors

Palmblad J,Lönnqvist B,Carlsson B,Grimfors G,Järnmark M,Lerner R,Ljungman P,Nyström-Rosander C,Petrini B,Oberg G

doi

10.1111/j.1365-2796.1992.tb00945.x

subject

Has Abstract

pub_date

1992-04-01 00:00:00

pages

363-70

issue

4

eissn

0954-6820

issn

1365-2796

journal_volume

231

pub_type

临床试验,杂志文章,多中心研究,随机对照试验

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