Azoles versus conventional amphotericin B for the treatment of candidemia: A meta-analysis of randomized controlled trials

Sumika Osa, Sho Tashiro, Yuki Igarashi, Yuki Watabe, Xiaoxi Liu, Yuki Enoki, Kazuaki Taguchi, Toshihiko Mayumi, Yoshitsugu Miyazaki, Yoshio Takesue, Kazuaki Matsumoto

研究成果: Article

抜粋

Because exclusive use of echinocandins can induce the drug-resistant strains, appropriate use of azoles and polyenes is still necessary in the treatment of candidemia. In this study, we conducted a meta-analysis of randomized controlled trials regarding the efficacy and safety of azole and polyene antifungals in the treatment of candidemia. MEDLINE and the Cochrane Register of Controlled Trials were used as reference databases, and papers published up to June 10, 2019 were searched. The search results were carefully scrutinized, duplicate references were removed, and the study was ultimately carried out using three reports. Among azole antifungals, fluconazole and voriconazole were extracted, however; only conventional amphotericin B (AMPH-B) was extracted among polyene antifungals. Treatment successes with the use of azoles and AMPH-B were compared, and findings showed that AMPH-B was significantly superior (RR = 0.90, 95% CI 0.82–1.00, p = 0.04). However, there was no significant difference in mortality (RR = 0.87, 95% CI 0.72–1.07, p = 0.19). Analysis of adverse events showed that renal disorders were significantly less common with azoles than with AMPH-B (RR = 0.26, 95% CI 0.10–0.68, p = 0.006). In conclusion, AMPH-B were superior to azoles in terms of efficacy, but had a risk of causing renal disorders.

元の言語English
ページ(範囲)1232-1236
ページ数5
ジャーナルJournal of Infection and Chemotherapy
26
発行部数11
DOI
出版物ステータスAccepted/In press - 2020

ASJC Scopus subject areas

  • Microbiology (medical)
  • Pharmacology (medical)
  • Infectious Diseases

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  • これを引用

    Osa, S., Tashiro, S., Igarashi, Y., Watabe, Y., Liu, X., Enoki, Y., Taguchi, K., Mayumi, T., Miyazaki, Y., Takesue, Y., & Matsumoto, K. (受理済み/印刷中). Azoles versus conventional amphotericin B for the treatment of candidemia: A meta-analysis of randomized controlled trials. Journal of Infection and Chemotherapy, 26(11), 1232-1236. https://doi.org/10.1016/j.jiac.2020.07.019