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Cited by 1,174

The DOI matches its Crossref record; 1 of the 1 references it cites were found in a registry or an index.

A Controlled Trial of Fluconazole to Prevent Fungal Infections in Patients Undergoing Bone Marrow Transplantation

Goodman, Jesse L., Winston, Drew J., Greenfield, Ronald A., Chandrasekar, Pranatharthi H., Fox, Barry, Kaizer, Herbert, Shadduck, Richard K., Shea, Thomas C., Stiff, Patrick, Friedman, David J., Powderly, William G., Silber, Jeffrey L., Horowitz, Harold, Lichtin, Alan, Wolff, Steven N., Mangan, Kenneth F., Silver, Samuel M., Weisdorf, Daniel, Ho, Winston G., Gilbert, Gene, Buell, Donald·1992·New England Journal of Medicine
DOI 10.1056/nejm199203263261301
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Abstract

BACKGROUND AND METHODS: 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. RESULTS: 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 placebo and in 8.4 percent of the patients receiving fluconazole (P less than 0.001). Systemic fungal infections occurred in 28 patients who received placebo as compared with 5 who received fluconazole (15.8 percent vs. 2.8 percent, P less than 0.001). Fluconazole prevented infection with all strains of candida except Candida krusei. Fluconazole was well tolerated, although patients who received it had a higher mean increase in alanine aminotransferase levels than patients who received placebo. Although there was no significant difference in overall mortality between the groups, fewer deaths were ascribed to acute systemic fungal infections in the group receiving fluconazole than in the group receiving placebo (1 of 179 vs. 10 of 177, P less than 0.001). CONCLUSIONS: Prophylactic administration of fluconazole to recipients of bone marrow transplants reduces the incidence of both systemic and superficial fungal infections.

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Metadata

Authors
Goodman, J. L., Winston, D. J., Greenfield, R. A., Chandrasekar, P. H., Fox, B., Kaizer, H., Shadduck, R. K., Shea, T. C., Stiff, P., Friedman, D. J., Powderly, W. G., Silber, J. L., Horowitz, H., Lichtin, A., Wolff, S. N., Mangan, K. F., Silver, S. M., Weisdorf, D., Ho, W. G., Gilbert, G., & Buell, D.
Venue
New England Journal of Medicine
Publisher
Massachusetts Medical Society
Published
1992-03-26
Volume
326
Issue
13
Pages
845-851
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
DOI
10.1056/nejm199203263261301
OpenAlex
W2341266869
Cited by
1,174
References
1
FWCI
52.97
Type
journal article
Language
en
Open access
closed

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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).

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