Drew J. Winston, MD; Richard T. Maziarz, MD; Pranatharthi H. Chandrasekar, MD; Hillard M. Lazarus, MD; Mitchell Goldman, MD; Jeffrey L. Blumer, PhD, MD; Gerhard J. Leitz, MD, PhD; Mary C. Territo, MD
Acknowledgments: The authors thank Ann Gogesch, RN, UCLA Medical Center, Los Angeles, California, and Mary Steigelman, RN, Harper University Hospital, Detroit, Michigan, for their valuable assistance during the study. They also thank Dr. Ronghua Yang, Larry Broach, and Katie Harding for performing data and statistical analyses and Katharine Fry for preparing the manuscript.
Grant Support: By Janssen Research Foundation, Titusville, New Jersey.
Potential Financial Conflicts of Interest:Employment: G.J. Leitz (Ortho Biotech); Consultancies: J.L. Blumer (Pfizer); Honoraria: D.J. Winston (Ortho Biotech and Pfizer), P.H. Chandrasekar (Pfizer), J.L. Blumer (Pfizer); Grants received: D.J. Winston (Janssen Research Foundation, Ortho Biotech, and Pfizer), P.H. Chandrasekar (Pfizer), M. Goldman (Janssen Research Foundation).
Requests for Single Reprints: Drew J. Winston, MD, Department of Medicine, UCLA Medical Center, Room 42-121 CHS, 10833 Le Conte Avenue, Los Angeles, CA 90095; e-mail, email@example.com.
Current Author Addresses: Dr. Winston: Department of Medicine, UCLA Medical Center, Room 42-121 CHS, 10833 Le Conte Avenue, Los Angeles, CA 90095.
Dr. Maziarz: Oregon Health and Sciences University, 3181 Southwest Sam Jackson Park Road, Portland, OR 97232.
Dr. Chandrasekar: Harper University Hospital, 4 Brush Center, 3990 John R, Detroit, MI 48201.
Dr. Lazarus: Ireland Cancer Center, University Hospitals of Cleveland, 11100 Euclid Avenue, Cleveland, OH 44106.
Dr. Goldman: Wishard Memorial Hospital, 430 OPW, 1001 West Tenth Street, Indianapolis, IN 46202.
Dr. Blumer: Rainbow Babies and Children's Hospital, 11100 Euclid Avenue, Cleveland, OH 44106.
Dr. Leitz: Ortho Biotech, 430 Route 22 East, Bridgewater, NJ 08807.
Dr. Territo: Department of Medicine, UCLA Medical Center, Room 42-121 CHS, 10833 Le Conte Avenue, Los Angeles, CA 90095.
Author Contributions: Conception and design: D.J. Winston.
Analysis and interpretation of the data: D.J. Winston, G.J. Leitz.
Drafting of the article: D.J. Winston.
Critical revision of the article for important intellectual content: D.J. Winston, R.T. Maziarz, P.H. Chandrasekar, H.M. Lazarus, M. Goldman, J.L. Blumer.
Final approval of the article: D.J. Winston, R.T. Maziarz, P.H. Chandrasekar, M.C. Territo.
Provision of study materials or patients: R.T. Maziarz, P.H. Chandrasekar, H.M. Lazarus, M. Goldman, J.L. Blumer, M.C. Territo.
Obtaining of funding: D.J. Winston.
Administrative, technical, or logistic support: G.J. Leitz.
Collection and assembly of the data: D.J. Winston.
Winston D., Maziarz R., Chandrasekar P., Lazarus H., Goldman M., Blumer J., Leitz G., Territo M.; Intravenous and Oral Itraconazole versus Intravenous and Oral Fluconazole for Long-Term Antifungal Prophylaxis in Allogeneic Hematopoietic Stem-Cell Transplant Recipients: A Multicenter, Randomized Trial. Ann Intern Med. 2003;138:705-713. doi: 10.7326/0003-4819-138-9-200305060-00006
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Published: Ann Intern Med. 2003;138(9):705-713.
Fungal infections have become an increasing cause of morbidity and death after allogeneic hematopoietic stem-cell transplantation. Indeed, with better prevention of cytomegalovirus disease, invasive fungal infections are now the leading cause of death from infection at many transplantation centers (1, 2). Consequently, antifungal agents are often used for prophylaxis in allogeneic hematopoietic stem-cell transplant recipients. An amphotericin B formulation or fluconazole has been most commonly used (3-11). Each of these agents, however, has substantial limitations for prophylaxis. The amphotericin B formulations are limited by toxicity, and the lipid preparations of amphotericin B can be expensive. Furthermore, the prophylactic efficacy of standard amphotericin B and the newer lipid formulations of amphotericin has not been consistently demonstrated in randomized, controlled trials (1, 5-11). Routine use of fluconazole for prophylaxis has been associated with the emergence of fluconazole-resistant Candida infections (12-14). Fluconazole also lacks reliable activity against Aspergillus species, which have now become the primary cause of invasive fungal infection at many transplantation centers (15, 16).
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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