SynthesisBMC infectious diseases2017
Empiric treatment against invasive fungal diseases in febrile neutropenic patients: a systematic review and network meta-analysis.
Synthesis in BMC infectious diseases, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 3 of them syntheses that pooled it.
What it found
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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.
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.
Who cites it
18 citing papers in PubMed, 3 syntheses or guidelines pooled it, 49 citations in OpenAlex.
- Liposomal amphotericin B prophylaxis in paediatrics: a systematic review.The Journal of antimicrobial chemotherapy · 2025Pooled it
- Pre-emptive antifungal therapy versus empirical antifungal therapy for febrile neutropenia in people with cancer.The Cochrane database of systematic reviews · 2022Pooled it
- Meta-analysis of the safety of voriconazole in definitive, empirical, and prophylactic therapies for invasive fungal infections.BMC infectious diseases · 2017Pooled it
- Trial
- COVID-19-Associated Fungal Co-Infections: Pathogenesis, Diagnostics, Biomarkers, and Therapeutic Strategies.Journal of clinical medicine · 2026Review
- Early Antifungal Treatment in Immunocompromised Patients, Including Hematological and Critically Ill Patients.Journal of fungi (Basel, Switzerland) · 2026Review
- Fever of unknown origin: cost of illness study.Open medicine (Warsaw, Poland) · 2026Article
- InvasiveMedical mycology case reports · 2024Article
- Review
- Epidemiology and source of infection in cancer patients with febrile neutropenia: an experience from a developing country.BMC infectious diseases · 2023Article
- Efficacy and Safety of Caspofungin Treatment in Febrile Neutropenic Patients with Hematological Disorders: A Multicenter Consecutive Case Series.Internal medicine (Tokyo, Japan) · 2022Article
- Real-World Financial and Clinical Impact of Diagnostic-Driven and Empirical-Treatment Strategies in High-Risk Immunocompromised Patients with Suspected Aspergillus Infection in the United Kingdom.Microbiology spectrum · 2022Article
- The Value of Nasal and Oral Clinical Examination in Febrile Neutropenic Patients for Initiating Antifungal Therapy as a Preemptive Method.Frontiers in medicine · 2021Article
- [Pharmacokinetic study of domestic caspofungin compared with original caspofungin for empirical therapy in patients with persistent fever and agranulocytosis].Zhonghua xue ye xue za zhi = Zhonghua xueyexue zazhi · 2020Article
- Critically ill patients with cancer: A clinical perspective.World journal of clinical oncology · 2020Review
- Development of Amphotericin B Micellar Formulations Based on Copolymers of Poly(ethylene glycol) and Poly(ε-caprolactone) Conjugated with Retinol.Pharmaceutics · 2020Article
- Epidemiology of Febrile Neutropenia Episodes with Gram-Negative Bacteria Infection in Patients Who Have Undergone Chemotherapy for Hematologic Malignancies: A Retrospective Study of 10 Years' Data from a Single Center.Infection and drug resistance · 2020Article
- Gut Leakage of Fungal-Derived Inflammatory Mediators: Part of a Gut-Liver-Kidney Axis in Bacterial Sepsis.Digestive diseases and sciences · 2019Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe most optimal antifungal agent for empiric treatment of invasive fungal diseases (IFDs) in febrile neutropenia is controversial. Our objective was evaluate the relative efficacy of antifungals for all-cause mortality, fungal infection-related mortality and treatment response in this population.
methodsPubmed, Embase and Cochrane Library were searched to identify randomized controlled trials (RCTs). Two reviewers performed the quality assessment and extracted data independently. Pairwise meta-analysis and network meta-analysis were conducted to compare the antifungals.
resultsSeventeen RCTs involving 4583 patients were included. Risk of bias of included studies was moderate. Pairwise meta-analysis indicated the treatment response rate of itraconazole was significantly better than conventional amphotericin B (RR = 1.33, 95%CI 1.10-1.61). Network meta-analysis showed that amphotericin B lipid complex, conventional amphotericin B, liposomal amphotericin B, itraconazole and voriconazole had a significantly lower rate of fungal infection-related mortality than no antifungal treatment. Other differences in outcomes among antifungals were not statistically significant. From the rank probability plot, caspofungin appeared to be the most effective agent for all-cause mortality and fungal infection-related mortality, whereas micafungin tended to be superior for treatment response. The results were stable after excluding RCTs with high risk of bias, whereas micafungin had the lowest fungal infection-related mortality.
conclusionsOur results highlighted the necessity of empiric antifungal treatment and indicates that echinocandins appeared to be the most effective agents for empiric treatment of febrile neutropenic patients based on mortality and treatment response. However, more studies are needed to determine the best antifungal agent for empiric treatment. Our systematic review has been prospectively registered in PROSPERO and the registration number was CRD42015026629.
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Registered trials
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.