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  • 1
    ISSN: 1439-0973
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Bei der systemischenCandida albicans-Infektion neutropenischer Mäuse wurden die relativen Aktivitäten von Cilofungin, Amphotericin B und Fluconazol verglichen. Die Überlebensraten nach 39 Tagen waren für Cilofungin mit 14,6% am niedrigsten, in einem mittleren Bereich mit Amphotericin B (37,6%) und am höchsten mit Fluconazol (50,5%). Residualinfektionen der Gewebe bei überlebenden Tieren waren bei allen Substanzen zu beobachten, sie waren bei Fluconazol-Anwendung am stärksten ausgeprägt und fanden sich vor allem in den Nieren.
    Notes: Summary The relative efficacies of cilofungin, amphotericin B and fluconazole were compared in the treatment of systemicCandida albicans infection in neutropenic mice. Thirty-one day survival rates were lowest for cilofungin (14.6%), intermediate for amphotericin B (37.6%) and highest for fluconazole (50.5%). Residual tissue infection in surviving animals was observed with all agents, but was heaviest with fluconazole, especially in the kidneys.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1435-4373
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A randomized trial was conducted to compare the efficacy and safety of fluconazole versus that of amphotericin B in the treatment of candidemia in non-neutropenic adults. Enrollment was stratified by disease severity (APACHE II score). Patients were randomized (1∶:1) to receive amphotericin B 0.6 mg/kg/day (cumulative dose 8 mg/kg) or fluconazole 800 mg intravenous loading dose, then 400 mg daily for four weeks (intravenous for at least 10 days). Patients were monitored for six months. A total of 106 patients were enrolled. A protocol amendment implemented midway through the trial required patients to be removed from the study and treated with amphotericin B if species identification indicated candidemia due toCandida glabrata orCandida krusei. Baseline characteristics were similar for the two groups; 103 patients (fluconazole, 50; amphotericin B, 53) met the major enrollment criteria. The intention-to-treat analysis indicated successful therapy in 50% of fluconazole recipients compared to 58% of the amphotericin B group (p=0.39; one-sided 95% Cl, −8 to 24%). The efficacy analysis included 84 patients (fluconazole, 42; amphotericin B, 42); successful outcomes were observed in 57% and 62% of cases in the fluconazole and amphotericin B groups, respectively (p=0.66: one-sided 95% Cl, −12 to 22%). The mortality at day 14 for the fluconazole group was 26% and for the amphotericin B group 21% (p=0.52; chi-square test) and remained similar throughout the course of follow-up. Drug-related adverse events were more frequent with amphotericin B than with fluconazole and prompted switching of therapy for two (4%) and zero cases, respectively. Fluconazole and amphotericin B were associated with similar clinical response rates and survival in the treatment of candidemia among non-neutropenic patients; however, drug-related adverse events were more frequent with amphotericin B.
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