Randomized trial of fluconazole versus nystatin for the prophylaxis of Candida infection following liver transplantation

被引:105
作者
Lumbreras, C
CuervasMons, V
Jara, P
delPalacio, A
Turrion, VS
Barrios, C
Moreno, E
Noriega, AR
Paya, CV
机构
[1] MAYO CLIN & MAYO FDN,DIV INFECT DIS,ROCHESTER,MN 55905
[2] UNIV AUTONOMA MADRID,HOSP PUERTA HIERRO,LIVER TRANSPLANTAT UNIT,E-28049 MADRID,SPAIN
[3] UNIV AUTONOMA MADRID,HOSP LA PAZ,LIVER TRANSPLANTAT UNIT,E-28049 MADRID,SPAIN
[4] UNIV COMPLUTENSE MADRID,HOSP DOCE OCTUBRE,MICROBIOL & SURG DEPT,INFECT DIS UNIT,E-28040 MADRID,SPAIN
关键词
D O I
10.1093/infdis/174.3.583
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
A prospective, randomized, multicenter study addressed the safety and efficacy of fluconazole therapy in 143 liver transplant patients, Seventy-six patients received daily oral fluconazole (100 mg), and 67 received nystatin (4 x 10(6) U) during the first 28 days after transplantation. Candida colonization occurred in 25% and 53% of patients in the fluconazole and nystatin groups, respectively (P = .04), and 13% and 34% of patients in the respective groups had Candida infections (P = .022). Of these patients, 10.5% in the fluconazole group and 25.3% in the nystatin group had superficial candidal infections (P = .024), Invasive candidiasis developed in 2 patients in the fluconazole group (2.6%) and 6 in the nystatin group (9.0%) (P = .12). There was no increased hepatotoxicity, cyclosporine interaction, or emergence of clinically relevant resistant Candida strains attributable to fluconazole, Thus, oral fluconazole (100 mg) is safe and reduces Candida colonization and infection after liver transplantation.
引用
收藏
页码:583 / 588
页数:6
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