OBJECTIVE: To study the efficacy of fluconazole against chronic disseminated candidiasis (hepatosplenic candidiasis) in patients with leukemia in whom amphotericin B treatment had failed. DESIGN: Retrospective analysis of patients with chronic disseminated candidiasis treated with fluconazole on a compassionate investigational new drug protocol. SETTING: Multi-institutional. PATIENTS AND METHODS: Twenty consecutive patients received 100 to 400 mg of fluconazole per day for a median of 30 weeks. All had either failed to respond to treatment with more than 2 g of amphotericin B or had serious amphotericin B-related toxicities. RESULTS: Fourteen of 16 evaluable patients (88%) responded. Responses were observed in seven of nine patients in whom adequate doses of amphotericin B had failed and in all seven patients who had amphotericin B-related toxicities. In 12 patients, cytotoxic chemotherapy was continued without flare of the infection. Fluconazole was well tolerated with rare side effects. Aspergillus superinfection developed in three patients and contributed to the death of two of them. CONCLUSION: Fluconazole is a safe and effective agent with significant activity against chronic disseminated candidiasis.
OBJECTIVE: To study the efficacy of fluconazole against chronic disseminated candidiasis (hepatosplenic candidiasis) in patients with leukemia in whom amphotericin B treatment had failed. DESIGN: Retrospective analysis of patients with chronic disseminated candidiasis treated with fluconazole on a compassionate investigational new drug protocol. SETTING: Multi-institutional. PATIENTS AND METHODS: Twenty consecutive patients received 100 to 400 mg of fluconazole per day for a median of 30 weeks. All had either failed to respond to treatment with more than 2 g of amphotericin B or had serious amphotericin B-related toxicities. RESULTS: Fourteen of 16 evaluable patients (88%) responded. Responses were observed in seven of nine patients in whom adequate doses of amphotericin B had failed and in all seven patients who had amphotericin B-related toxicities. In 12 patients, cytotoxic chemotherapy was continued without flare of the infection. Fluconazole was well tolerated with rare side effects. Aspergillus superinfection developed in three patients and contributed to the death of two of them. CONCLUSION:Fluconazole is a safe and effective agent with significant activity against chronic disseminated candidiasis.
Authors: P Phillips; S Shafran; G Garber; C Rotstein; F Smaill; I Fong; I Salit; M Miller; K Williams; J M Conly; J Singer; S Ioannou Journal: Eur J Clin Microbiol Infect Dis Date: 1997-05 Impact factor: 3.267
Authors: Eric J Bow; Gerald Evans; Jeff Fuller; Michel Laverdière; Coleman Rotstein; Robert Rennie; Stephen D Shafran; Don Sheppard; Sylvie Carle; Peter Phillips; Donald C Vinh Journal: Can J Infect Dis Med Microbiol Date: 2010 Impact factor: 2.471
Authors: Jordi Rello; Despoina Koulenti; Stijn Blot; Rafael Sierra; Emili Diaz; Jan J De Waele; Antonio Macor; Kemal Agbaht; Alejandro Rodriguez Journal: Intensive Care Med Date: 2007-03-24 Impact factor: 17.440
Authors: J L Vincent; E Anaissie; H Bruining; W Demajo; M el-Ebiary; J Haber; Y Hiramatsu; G Nitenberg; P O Nyström; D Pittet; T Rogers; P Sandven; G Sganga; M D Schaller; J Solomkin Journal: Intensive Care Med Date: 1998-03 Impact factor: 17.440
Authors: A J Fischman; N M Alpert; E Livni; S Ray; I Sinclair; R J Callahan; J A Correia; D Webb; H W Strauss; R H Rubin Journal: Antimicrob Agents Chemother Date: 1993-06 Impact factor: 5.191