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Preemptive Antifungal Therapy for Febrile Neutropenic Hematological Malignancy Patients in China
- Source :
- Medical Science Monitor : International Medical Journal of Experimental and Clinical Research
- Publication Year :
- 2016
- Publisher :
- International Scientific Literature, Inc., 2016.
-
Abstract
- BACKGROUND The aim of this study was to evaluate the efficiency, adverse effects, and pharmacoeconomic impact of empirical and preemptive antifungal therapy for febrile neutropenic hematological malignancy patients in China. MATERIAL AND METHODS Patients with febrile neutropenia during hematological malignancy were randomly divided into an empirical group and a preemptive group. The preemptive antifungal treatment was initiated if patient status was confirmed by clinical manifestation, imaging diagnosis, 1-3-β-D glucan(G) testing, and galactomannan (GM) test. The treatment was ended 2 weeks later if the patient was recovered from neutropenia. Voriconazole was used as the first-line medicine. All patients received intravenous administration of voriconazole every 12 h, with an initiating dose of 400 mg, then the dose was reduced to 200 mg. RESULTS The overall survival rate was 97.1% and 94.6% in the empirical group and preemptive group, respectively, with no significant difference observed (χ²=1.051, P=0.305). However, the occurrence rate of invasive fungal disease (IFD) in the preemptive group was 9.2% vs. 2.2% in the empirical group. Moreover, the mortality rate due to IFD was 0.7% and 2.3% for the empirical group and preemptive group, respectively. The average duration and cost of preemptive antifungal therapy were 13.8±4.7 days and 8379.00±2253.00 RMB, respectively, which were lower than for empirical therapy. However, no significant differences were observed for incidence of adverse effects and hospital stay between the 2 groups. CONCLUSIONS Preemptive antifungal therapy for patients with febrile neutropenic hematological malignancy demonstrated a similar survival rate as with empirical therapy but is economically favorable in a Chinese population.
- Subjects :
- 0301 basic medicine
Adult
Male
medicine.medical_specialty
China
Antifungal Agents
Adolescent
030106 microbiology
Neutropenia
law.invention
03 medical and health sciences
Young Adult
0302 clinical medicine
Randomized controlled trial
law
Clinical Research
Internal medicine
Hematologic Agents
medicine
Humans
030212 general & internal medicine
Intensive care medicine
Adverse effect
Survival rate
Aged
Febrile Neutropenia
Voriconazole
business.industry
Incidence (epidemiology)
Mortality rate
General Medicine
Middle Aged
medicine.disease
Hematologic Diseases
Survival Rate
Mycoses
Hematologic Neoplasms
Female
business
Febrile neutropenia
medicine.drug
Subjects
Details
- Language :
- English
- ISSN :
- 16433750 and 12341010
- Volume :
- 22
- Database :
- OpenAIRE
- Journal :
- Medical Science Monitor : International Medical Journal of Experimental and Clinical Research
- Accession number :
- edsair.doi.dedup.....ca77c834956c2e17debcfcd0dbd4ccae