Document Detail


Oral voriconazole for empiric antifungal treatment in patients with uncomplicated febrile neutropenia.
MedLine Citation:
PMID:  18154475     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
STUDY OBJECTIVE: To determine the success rate and toxicity profile of oral voriconazole when used as empiric antifungal therapy in patients with uncomplicated persistent neutropenic fever. DESIGN: Retrospective medical record review. SETTING: University hospital. PATIENTS: Twenty-seven patients who received oral voriconazole as empiric antifungal treatment during 31 episodes of persistent neutropenic fever between August 1, 2003, and April 1, 2006. MEASUREMENTS AND MAIN RESULTS: Data were collected on patient demographics, diagnosis, cancer treatment plan, voriconazole regimen, dates of voriconazole treatment, other antibiotics administered during the episode of fever, and adverse events. Patient survival data from at least 3 months of follow-up were also collected. Treatment success, which was defined as survival to the resolution of fever without a need to change antibiotics and without new fungal infections, was also determined. Median duration of therapy was 11 days (range 2-54 days). No patient discontinued the drug because of toxicity. The success rate was 55% (95% confidence interval [CI] 36-73%). For all patients, 90-day survival from the start of voriconazole treatment was 81% (95% CI 63-93%). Neither treatment success nor 90-day survival rates differed significantly when they were compared by the route used for loading doses or by the presence of a possible invasive fungal infection at the start of voriconazole therapy. CONCLUSION: Oral voriconazole appears to be a safe empiric antifungal treatment with an encouraging rate of activity for patients with neutropenia and uncomplicated persistent fever. Further research, including randomized controlled trials comparing the efficacy of intravenous versus oral voriconazole, is needed.
Authors:
Donna Przepiorka; Francis K Buadi; Brian McClune
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pharmacotherapy     Volume:  28     ISSN:  0277-0008     ISO Abbreviation:  Pharmacotherapy     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2007-12-24     Completed Date:  2008-05-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8111305     Medline TA:  Pharmacotherapy     Country:  United States    
Other Details:
Languages:  eng     Pagination:  58-63     Citation Subset:  IM    
Affiliation:
University of Tennessee Blood and Marrow Transplant Center, Memphis, Tennessee 38104, USA. gvhdoc@pdq.net
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MeSH Terms
Descriptor/Qualifier:
Administration, Oral
Adult
Aged
Alanine Transaminase / blood
Antifungal Agents / administration & dosage,  adverse effects,  therapeutic use
Aspartate Aminotransferases / blood
Bilirubin / blood
Creatinine / blood
Exanthema / chemically induced
Female
Fever / complications,  drug therapy*
Humans
Injections, Intravenous
Male
Middle Aged
Mycoses / complications,  drug therapy*
Neutropenia / complications,  drug therapy*
Pyrimidines / administration & dosage,  adverse effects,  therapeutic use*
Retrospective Studies
Time Factors
Treatment Outcome
Triazoles / administration & dosage,  adverse effects,  therapeutic use*
Chemical
Reg. No./Substance:
0/Antifungal Agents; 0/Pyrimidines; 0/Triazoles; 0/voriconazole; 60-27-5/Creatinine; 635-65-4/Bilirubin; EC 2.6.1.1/Aspartate Aminotransferases; EC 2.6.1.2/Alanine Transaminase

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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