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Intravenous itraconazole compared with liposomal amphotericin B as empirical antifungal therapy in patients with neutropaenia and persistent fever

Mycoses Jun 03, 2020

Yoshida I, Saito AM, Tanaka S, et al. - Researchers sought to compare the safety and efficacy of intravenous itraconazole (ivITCZ) vs liposomal amphotericin B (LAmB) as empirical antifungal therapy in patients with haematological malignancies with neutropaenia and persistent fever via performing this multicenter, open‐label, randomized, non‐inferiority trial. In the LAmB and ivITCZ groups, 17/52 (32.7%) and 18/50 (36.0%), respectively exhibited overall favorable response rates. Two cases of breakthrough infection and five cases of probable invasive fungal disease occurred in the LAmB group, while no patient in the itraconazole group had either breakthrough infection or probable invasive fungal disease. Relative to LAmB group patients, the ivITCZ group patients had significantly fewer grade 3‐4 hypokalaemia‐related events. The ivITCZ group had overall lower incidence of adverse events. Findings here suggest similar efficacy and safety of ivITCZ vs LAmB as empirical antifungal therapy in haematological malignancy patients with febrile neutropaenia. However, the non‐inferiority of ivITCZ was not proved because of the small sample size and various limitations.  

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