Trial reportEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology1997
Multicenter randomized trial of fluconazole versus amphotericin B for treatment of candidemia in non-neutropenic patients. Canadian Candidemia Study Group.
Trial report in European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 1997. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 5 of them syntheses that pooled 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.
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
35 citing papers in PubMed, 5 syntheses or guidelines pooled it, 220 citations in OpenAlex.
- ECIL-6 guidelines for the treatment of invasive candidiasis, aspergillosis and mucormycosis in leukemia and hematopoietic stem cell transplant patients.Haematologica · 2017Guideline
- Antifungal treatment for invasive Candida infections: a mixed treatment comparison meta-analysis.Annals of clinical microbiology and antimicrobials · 2009Pooled it
- [Diagnosis and therapy of sepsis. Guidelines of the German Sepsis Society Inc. and the German Interdisciplinary Society for Intensive and Emergency Medicine].Der Internist · 2006Guideline
- Adverse effects of antifungal therapies in invasive fungal infections: review and meta-analysis.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2006Pooled it
- Adverse effects of antifungal therapies in invasive fungal infections: review and meta-analysis.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2005Pooled it
- International, open-label, noncomparative, clinical trial of micafungin alone and in combination for treatment of newly diagnosed and refractory candidemia.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2005Trial
- Economic analysis of fluconazole versus amphotericin B for the treatment of candidemia in non-neutropenic patients.PharmacoEconomics · 1998Trial
- Practice guideline on the prevention and treatment of central line-associated bloodstream infection: Part 2 - Treatment.Journal of intensive medicine · 2026Article
- Persistent Candidemia in adults: underlying causes and clinical significance in the antifungal stewardship era.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2019Article
- Treatment of Invasive Candidiasis: A Narrative Review.Journal of fungi (Basel, Switzerland) · 2018Review
- Fungicidal versus fungistatic therapy of invasiveMycology · 2018Article
- "De-escalation" strategy using micafungin for the treatment of systemicClinicoEconomics and outcomes research : CEOR · 2017Article
- Potent Synergy between Spirocyclic Pyrrolidinoindolinones and Fluconazole against Candida albicans.ChemMedChem · 2015Article
- [Strategies for antifungal treatment failure in intensive care units].Der Anaesthesist · 2015Review
- Small intestinal fungal overgrowth.Current gastroenterology reports · 2015Review
- Review
- Fungal infections: their diagnosis and treatment in transplant recipients.International journal of hepatology · 2012Article
- Use of antifungal drugs in hematology.Revista brasileira de hematologia e hemoterapia · 2012Article
- Article
- [Update: invasive fungal infections: Diagnosis and treatment in surgical intensive care medicine].Der Anaesthesist · 2010Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
12 authors at 10 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
A randomized trial was conducted to compare the efficacy and safety of fluconazole versus that of amphotericin B in the treatment of candidemia in non-neutropenic adults. Enrollment was stratified by disease severity (APACHE II score). Patients were randomized (1:1) to receive amphotericin B 0.6 mg/kg/day (cumulative dose 8 mg/kg) or fluconazole 800 mg intravenous loading dose, then 400 mg daily for four weeks (intravenous for at least 10 days). Patients were monitored for six months. A total of 106 patients were enrolled. A protocol amendment implemented midway through the trial required patients to be removed from the study and treated with amphotericin B if species identification indicated candidemia due to Candida glabrata or Candida krusei. Baseline characteristics were similar for the two groups; 103 patients (fluconazole, 50; amphotericin B, 53) met the major enrollment criteria. The intention-to-treat analysis indicated successful therapy in 50% of fluconazole recipients compared to 58% of the amphotericin B group (p = 0.39; one-sided 95% CI, -8 to 24%). The efficacy analysis included 84 patients (fluconazole, 42; amphotericin B, 42); successful outcomes were observed in 57% and 62% of cases in the fluconazole and amphotericin B groups, respectively (p = 0.66: one-sided 95% CI, -12 to 22%). The mortality at day 14 for the fluconazole group was 26% and for the amphotericin B group 21% (p = 0.52; chi-square test) and remained similar throughout the course of follow-up, Drug-related adverse events were more frequent with amphotericin B than with fluconazole and prompted switching of therapy for two (4%) and zero cases, respectively. Fluconazole and amphotericin B were associated with similar clinical response rates and survival in the treatment of candidemia among non-neutropenic patients; however, drug-related adverse events were more frequent with amphotericin B.
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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.