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Itraconazole versus Fluconazole for Antifungal Prophylaxis
- Drew J. Winston, MD;
- Richard T. Maziarz; and
- Pranatharthi H. Chandrasekar, MD
- From University of California, Los Angeles, Medical Center, Los Angeles, CA 90095; Oregon Health & Science University, Portland, OR 97232; and Harper University Hospital, Detroit, MI 48201.
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IN RESPONSE:
We do not dispute the efficacy of fluconazole for prevention of Candida infections in transplant recipients (1, 2). However, the usefulness of fluconazole for antifungal prophylaxis in recipients of allogeneic hematopoietic stem-cell transplants has recently been compromised by the increasing incidence of Aspergillus and certain fluconazole-resistant Candida infections. Furthermore, while the Seattle study reported improved long-term survival in patients receiving prophylactic fluconazole after allogeneic hematopoietic stem-cell transplantation (3), these …
