Evidence map›Paper›PMID 12519566›Full record

SynthesisThe Cochrane database of systematic reviews2002

Nystatin prophylaxis and treatment in severely immunodepressed patients.

P C Gøtzsche, H K Johansen

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in The Cochrane database of systematic reviews, 2002. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Trial
  5. Topical polyene antifungals in hematopoietic cell transplant patients: tolerability and efficacy.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2004
    Trial
  6. Article
  7. Microorganisms · 2020
    Review
  8. Article
  9. Fungal infections in renal transplant patients.Journal of clinical medicine research · 2015
    Review
  10. Review
  11. Article
  12. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

2 authors.

P C GøtzscheThe Nordic Cochrane Centre, Rigshospitalet, Dept. 7112, Blegdamsvej 9, Copenhagen Ø, Denmark, 2100. p.c.gotzsche@cochrane.dk
H K Johansen

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNystatin is sometimes used prophylactically in patients with severe immunodeficiency or in the treatment of fungal infection in such patients, although the effect seems to be equivocal.

objectivesTo study whether nystatin decreases morbidity and mortality when given prophylactically or therapeutically to patients with severe immunodeficiency. SEARCH STRATEGY: MEDLINE and The Cochrane Library using a comprehensive search strategy, date of last search November 2001. Contacted industry and scanned reference lists. SELECTION CRITERIA: Randomised trials comparing nystatin with placebo, an untreated control group, fluconazole or amphotericin B. DATA COLLECTION AND ANALYSIS: Data on mortality, invasive fungal infection and colonisation were extracted by both authors independently. A random effects model was used unless p>0.10 for the test of heterogeneity. MAIN

resultsWe included 12 trials (1,464 patients). The drugs were given prophylactically in ten trials and as treatment in two. Seven trials were in acute leukaemia, two in cancer, one in liver transplant patients, one in critically ill surgical and trauma patients, and one in AIDS patients. Nystatin had been compared with placebo in three trials and with fluconazole in nine; the dose varied from 1.5 MIE to 72 MIE daily. The effect of nystatin was similar to that of placebo on fungal colonisation (relative risk 0.85, 95% confidence interval 0.65 to 1.13). There was no statistically significant difference between fluconazole and nystatin on mortality (relative risk 0.76, 0.49 to 1.18) whereas fluconazole was more effective in preventing invasive fungal infection (relative risk 0.37, 0.15 to 0.91) and colonisation (relative risk 0.49, 0.34 to 0.70). The results were very similar if the three studies which were not performed in cancer patients were excluded. REVIEWER'S

conclusionsNystatin cannot be recommended for prophylaxis or treatment of Candida infections in immunodepressed patients.

Indexed as

Antibiotic ProphylaxisImmunocompromised HostAmphotericin BAntifungal AgentsFluconazoleHumansMycosesNystatinOpportunistic InfectionsRandomized Controlled Trials as TopicAmphotericin BAntifungal AgentsFluconazoleNystatin

Identifiers

PMID12519566

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.