Table 1 |
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Randomized multicentre clinical trials of antifungal therapy in patients with candidaemia or invasive candidiasis |
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Pappas et al. [30] |
Mora-Duarte et al. [32] |
Kuse et al. [34] |
Reboli et al. [35] |
Kullberg et al. [33] |
Rex et al. [31] |
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Micafungin |
Micafungin |
Caspofungin |
Caspofungin |
Amphotericin B deoxycholate |
Micafungin |
Liposomal amphotericin B |
Anidulafungin |
Fluconazole |
Voriconazole |
Amphotericin B deoxycholate followed by fluconazole |
Fluconazole |
Amphotericin B deoxycholate |
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Daily dose |
100 mga |
150 mga |
70 mg load, followed by 50 mga |
70 mg load, followed by 50 mga |
0.6 to 0.7 mg/kga |
100 mg |
3 mg/kg |
200 mg load, followed by 100 mga |
800 mg load, followed by 400 mga |
6 mg/kg twice daily day 1, followed by 3 mg/kg twice daily |
0.7 to 1 mg/kg, day 3 to 7 iv/oral. Fluconazole 400 mg |
400 mgb |
0.5 to0.6 mg/kg |
|
Number of patients |
191 |
199 |
188 |
114 |
125 |
264 |
267 |
132 |
129 |
272 |
131 |
113 |
111 |
|
Mean APACHE II score |
14.9 |
14.7 |
13.8 |
14.8 |
15.4 |
15.8 |
15.6 |
15.0 |
14.4 |
13.8 |
14.7 |
16 |
16 |
|
Neutrophil count <500/mm3 |
11.5% |
8.5% |
5.9% |
12.8% |
8.7% |
13% |
10% |
2% |
3% |
Exclusion criterion |
Exclusion criterion |
Exclusion criterion |
Exclusion criterion |
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Candida spp. |
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C. albicans |
48.2% |
51.3% |
44.1% |
35.6% |
54.1% |
42% |
44% |
64% |
59% |
43% |
21% |
68% |
61% |
|
Non-albicans |
54.5% |
51.3% |
60.6% |
64.4% |
45.9% |
62% |
59% |
43% |
50% |
61% |
50% |
32% |
39% |
|
C. glabrata |
14.7% |
17.1% |
17.6% |
12.8% |
9.2% |
11% |
7.4% |
16% |
25% |
15% |
17% |
12.6% |
10.6% |
|
C. krusei |
4.2% |
4.0% |
2.1% |
4% |
0.9% |
3% |
3.5% |
NR |
NR |
2% |
1% |
1.9% |
1% |
|
Site of infection |
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Blood only |
85.3% |
84.4% |
85.6% |
82.6% |
79.1% |
84% |
86% |
91% |
87% |
96% |
96% |
70% |
74% |
|
Blood and other site |
NR |
NR |
NR |
4.6% |
3.5% |
NR |
NR |
3% |
3% |
4% |
4% |
30% |
26% |
|
Other site only |
14.7% |
15.1% |
13.8% |
12.8% |
17.4% |
16% |
14% |
6% |
9% |
NR |
NR |
NR |
NR |
|
Days of therapy |
14 (median) |
14(median) |
14 (median) |
12.1 (mean) |
11.7 (mean) |
15 (median) |
15 (median) |
15.9 (mean) |
14.4 (mean) |
15 (median) |
15 (median) |
18 (mean) |
17 (mean) |
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Success of therapyc |
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At end of iv therapy |
76.4% |
71.4% |
72.3% |
73.4% |
61.7% |
74.1% |
69.6% |
75.6% |
60.2% |
70% |
74% |
74% |
83% |
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C. glabrata infectiond |
85.7% |
88.2% |
66.7% |
76.9% |
80% |
82.6%e |
80.0%e |
75% |
60% |
33%f |
33%f |
NR |
NR |
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Neutropeniad |
81.8% |
52.9% |
63.6% |
50% |
40% |
59.4% |
56.0% |
NR |
NR |
NR |
NR |
NR |
NR |
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Drug-related toxicityg |
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Adverse eventsh |
22% |
22.8% |
23.8% |
42.1% |
75.2% |
43.2% |
50.9% |
24.4%i |
26.4%i |
46% |
57% |
NR |
NR |
|
Therapy discontinuation |
2.5% |
3.0% |
3.6% |
2.6% |
23.2% |
4.9% |
9.0% |
NR |
NR |
6% |
5% |
2.9%i |
3.8%i |
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aSwitch to oral fluconazole (400 mg) possible after 10 days of intravenous therapy. bSwitch to oral fluconazole (400 mg) possible after 7 days of intravenous therapy. cModified intention-to-treat analyses, if not specified otherwise. dAt end of study drug administration, if not specified otherwise. e Per protocol analyses. f Response at 12-week follow-up visit. gIntention-to-treat analyses, if not specified otherwise. hClinical event and/or laboratory abnormality. iModified intention-to-treat analyses. APACHE, Acute Physiology and Chronic Health Evaluation; iv, intravenous; NR, not reported. |
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Méan et al. Critical Care 2008 12:204 doi:10.1186/cc6212 |
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