Evidence map›Paper›PMID 15266524›Full record

SynthesisThe Cochrane database of systematic reviews2004

Antifungal agents for preventing fungal infections in solid organ transplant recipients.

E G Playford, A C Webster, T C Sorell, J C Craig

Open access · greenAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in The Cochrane database of systematic reviews, 2004. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
27citing papers in PubMed, 6 pooled it
2.1field-weighted citation impact, top 14% of its field
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

27 citing papers in PubMed, 6 syntheses or guidelines pooled it, 90 citations in OpenAlex.

  1. Antifungal prophylaxis in lung transplant recipients: A systematic review and meta-analysis.Transplant infectious disease : an official journal of the Transplantation Society · 2020
    Pooled it
  2. Practice Guidelines for the Diagnosis and Management of Aspergillosis: 2016 Update by the Infectious Diseases Society of America.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2016
    Guideline
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Trial
  8. Article
  9. Review
  10. Article
  11. Antifungal stewardship in solid organ transplantation.Transplant infectious disease : an official journal of the Transplantation Society · 2022
    Review
  12. Pacemaker-relatedBMJ case reports · 2021
    Article
  13. Cryptococcosis in Hematopoietic Stem Cell Transplant Recipients: A Rare Presentation Warranting Recognition.The Canadian journal of infectious diseases & medical microbiology = Journal canadien des maladies infectieuses et de la microbiologie medicale · 2020
    Review
  14. Article
  15. Article
  16. Fungal infections in renal transplant patients.Journal of clinical medicine research · 2015
    Review
  17. Article
  18. Care of the liver transplant patient.Canadian journal of gastroenterology & hepatology · 2014
    Review
  19. Evaluation of inconsistency in networks of interventions.International journal of epidemiology · 2013
    Article
  20. Use of antifungal agents in pediatric and adult high-risk areas.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2012
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 4 institutions in 1 country.

E G PlayfordInfection Management Services, Princess Alexandra Hospital, Ipswich Rd, Woolloongabba, QLD, Australia, 4102. geoffrey_playford@health.qld.gov.au
A C Webster
T C Sorell
J C Craig
Children's Hospital at Westmead · AUPrincess Alexandra Hospital · AUThe University of Sydney · AUWestmead Hospital · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundInvasive fungal infections (IFIs) are important causes of morbidity and mortality in solid organ transplant recipients.

objectivesThis study aims to systematically identify and summarise the effects of antifungal prophylaxis in solid organ transplant recipients. SEARCH STRATEGY: The Cochrane Central Register of Controlled Trials (Issue 3, 2003), MEDLINE (1966-June 2003), and EMBASE (1980-June 2003) were searched. Reference lists, abstracts of conference proceedings and scientific meetings (1998-2003) were handsearched. Authors of included studies and pharmaceutical manufacturers were contacted. SELECTION CRITERIA: Randomised controlled trials (RCTs) in all languages comparing the prophylactic use of any antifungal agent or regimen with placebo, no antifungal, or another antifungal agent or regimen. DATA COLLECTION AND ANALYSIS: Two reviewers independently applied selection criteria, performed quality assessment, and extracted data using an intention-to-treat approach. Differences were resolved by discussion. Data were synthesised using the random effects model and expressed as relative risk (RR) with 95% confidence intervals (95% CI). MAIN

resultsFourteen unique trials with 1497 randomised participants were included. Antifungal prophylaxis did not reduce mortality (RR 0.90, 95% CI 0.57 to 1.44). In liver transplant recipients, a significant reduction in IFIs was demonstrated for fluconazole (RR 0.28, 95% CI 0.13 to 0.57). Although less data were available for itraconazole and liposomal amphotericin B, indirect comparisons and one direct comparative trial suggested similar efficacy. Fluconazole prophylaxis did not significantly increase invasive infections or colonisation with fluconazole-resistant fungi. In renal and cardiac transplant recipients, neither ketoconazole nor clotrimazole significantly reduced invasive infections. Overall, the strength and precision of comparisons however were limited by a paucity of data. REVIEWERS'

conclusionsFor liver transplant recipients, antifungal prophylaxis with fluconazole significantly reduces the incidence of IFIs with no definite mortality benefit. Given a 10% incidence of IFI, 14 liver transplant recipients would require fluconazole prophylaxis to prevent one infection. In transplant centres where the incidence of IFIs is high, or in situations where the individual risk is great, antifungal prophylaxis should be considered.

Indexed as

Organ TransplantationAntifungal AgentsFluconazoleHumansImmunocompromised HostLiver TransplantationMycosesRandomized Controlled Trials as TopicAntifungal AgentsFluconazole

Identifiers

PMID15266524
PMCPMC12318630
OpenAlexW1836488607

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.