Systematic review and meta-analysis of antifungal agents for preventing fungal infections in liver transplant recipients

Playford, E. G.; Webster, A. C.; Sorrell, T. C.; Craig, J. C.
September 2006
European Journal of Clinical Microbiology & Infectious Diseases;Sep2006, Vol. 25 Issue 9, p549
Academic Journal
A systematic review and meta-analysis was performed to evaluate the benefits and harms of antifungal prophylaxis in liver transplant recipients. Ten randomised trials comparing any prophylactic antifungal regimen with no antifungal agent or with another antifungal regimen were identified from Medline, EMBASE, the Cochrane Library, and other sources. Together, the studies included a total of 1,106 patients. In general, results were consistent across trials despite clinical and methodological heterogeneity. Antifungal prophylaxis did not reduce total mortality (RR 0.84, 95% CI: 0.54–1.3). Fluconazole prophylaxis reduced invasive fungal infections by about 75% (RR 0.28, 95% CI: 0.13–0.57). Although fewer data on prophylactic itraconazole and liposomal amphotericin B were available, indirect comparisons and three direct comparative trials suggested similar efficacy. Fluconazole prophylaxis did not significantly increase colonisation or infection with azole-resistant fungi, although data were limited. A subgroup analysis suggested a dose and duration effect. In conclusion, fluconazole prophylaxis significantly reduces invasive fungal infections in liver transplant recipients and should be instituted in patients at increased risk in the early postoperative period.


Related Articles

  • Amphocil.  // Royal Society of Medicine: Medicines;2002, p55 

    The article provides information on Amphocil, a proprietary, prescription-only preparation of the antifungal drug amphotericin, in a formulation as a lipid colloidal dispersion that is intended to minimize toxicity, and can be used for severe systemic fungal infections. It is available in a form...

  • Quantitative and Qualitative Analysis of the Antifungal Activity of Allicin Alone and in Combination with Antifungal Drugs. Young-Sun Kim; Kyung Sook Kim; Ihn Han; Mi-Hyun Kim; Min Hyung Jung; Hun-Kuk Park // PLoS ONE;Jun2012, Vol. 7 Issue 6, p1 

    The antifungal activity of allicin and its synergistic effects with the antifungal agents flucytosine and amphotericin B (AmB) were investigated in Candida albicans (C. albicans). C. albicans was treated with different conditions of compounds alone and in combination (allicin, AmB, flucytosine,...

  • Antifungal Combination Therapy: Clinical Potential. Baddley, John W.; Pappas, Peter G. // Drugs;2005, Vol. 65 Issue 11, p1461 

    Combination antifungal therapy has been an area of research and clinical interest since systemic antifungals became available decades ago. In vitro and clinical data were generated for some of the more common invasive fungal infections, especially candidiasis, but until very recently few...

  • Prospective Study of Amphotericin B Formulations in Immunocompromised Patients in 4 European Countries. Ullmann, Andrew J.; Sanz, Miguel A.; Tramarin, Andrea; Barnes, Rosemary A.; Wu, Wenchen; Gerlach, Barbara A.; Krobot, Karl J.; Gerth, William C. // Clinical Infectious Diseases;8/15/2006, Vol. 43 Issue 4, pe29 

    Background. Amphotericin B is a widely used broad-spectrum antifungal agent, despite being associated with significant adverse events, including nephrotoxicity. Methods. The present prospective study collected data on outcomes for 418 adult patients treated consecutively with polyenes in...

  • In vitro activity of amphotericin B, itraconazole, terbinafine and 5-fluocytosine against Exophiala spinifera and evaluation of post-antifungal effects. Vitale, R. G.; De Hoog, G. S.; Verweij, Paul E. // Medical Mycology;Aug2003, Vol. 41 Issue 4, p301 

    Antifungal susceptibility profiles were determined for 16 strains of the black yeast Exophiala spinifera applying different temperature regimens. Fluconazole was the least effective in vitro . Lowest minimal inhibitory concentration (MIC) values were found with itraconazole. The activities of...

  • Amphotericin.  // Royal Society of Medicine: Medicines;2002, p55 

    The article provides information on amphotericin, a broad-spectrum antifungal which is a polyene antibiotic. It can be used particularly to treat infection by most fungi and yeasts and is an extremely important drug in the treatment of systemic fungal infections, when it is given by intravenous...

  • Amphotericin B: an antifungal drug in nanoformulations for the treatment of paracoccidioidomycosis. Garcia, Mônica Pereira; de Fátima Menezes Almeida Santos, Maria; Saldanha, Camila Arruda; Iocca, Diêgo Cesar; Azevedo, Ricardo Bentes // Revista Salud UIS;2013, Vol. 45 Issue 3, p45 

    The use of magnetic nanoparticles (MNPs) in drug delivery vehicles must address issues such as drugloading capacity, desired release profile, aqueous dispersion stability, biocompatibility with cells and tissue, and retention of magnetic properties after interaction with macromolecules or...

  • Susceptibility of fungi isolated from the respiratory tract of falcons to amphotericin B, itraconazole and voriconazole. Silvanose, C. D.; Bailey, T. A.; Di Somma, A. // Veterinary Record: Journal of the British Veterinary Association;8/26/2006, Vol. 159 Issue 9, p282 

    The minimum inhibitory concentrations (MICs) of fungi isolated from the air sacs of falcons before (group 1), and during antifungal treatment with amphotericin B nebulisation and oral itraconazole or voriconazole (group 2), or with itraconazole alone (group 3) or voriconazole alone (group 4)...

  • Prevalence and antifungal susceptibility patterns of new cryptic species inside the species complexes Candida parapsilosis and Candida glabrata among blood isolates from a Spanish tertiary hospital. Miranda-Zapico, Ilargi; Eraso, Elena; Hernández-Almaraz, José Luis; López-Soria, Leyre Mónica; Carrillo-Muñoz, Alfonso Javier; Hernández-Molina, Juan Manuel; Quindós, Guillermo // Journal of Antimicrobial Chemotherapy (JAC);Oct2011, Vol. 66 Issue 10, p2315 

    Objectives There is scarce information on the clinical relevance and antifungal susceptibility of Candida bracarensis, Candida nivariensis, Candida orthopsilosis and Candida metapsilosis. The objective of this study was to assess the prevalence and in vitro antifungal susceptibility of these...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics