Table 1. Major prospective randomized controlled trials of invasive candidiasis.
Author, Year | Comparators | Number Enrolled* | Proportion Candidemic (%) | C. albicans Infections (%) | End of Therapy Success (%) | Significance (P value) | Comments | |
---|---|---|---|---|---|---|---|---|
Rex 1994 [122] | Fluconazole | 113 | 100 | 70 | 72 | 0.17 | Non-neutropenic population; Less toxicity with fluconazole. |
|
Amphotericin B | 111 | 100 | 63 | 80 | ||||
Rex 2003[123] | Fluconazole plus Placebo | 107 | 100 | 68 | 56 | 0.043 | Higher APACHE II scores in fluconazole arm; Mortality not improved with combination; Higher nephrotoxicity with combination. |
|
Fluconazole plus Amphotericin B | 112 | 100 | 68 | 69 | ||||
Kullberg 2005[124] | Voriconazole | 248 | 100 | 43 | 70 | 0.42 | Non-blinded, non-neutropenic population; More renal toxicity & SAEs with AmB. |
|
Amphotericin B followed by Fluconazole | 122 | 100 | 51 | 74 | ||||
Mora-Duarte 2002[125] | Caspofungin | 109 | 83 | 36 | 73 | 0.09 | No difference in mortality; More drug related adverse events with AmB. |
|
Amphotericin B | 115 | 79 | 54 | 62 | ||||
Kuse 2007[126] | Micafungin | 264 | 83 | 39 | 74 | NS | 12% of study population neutropenic | |
LAMB | 267 | 84 | 43 | 70 | ||||
Reboli 2007[127] | Anidulafungin | 127 | 91 | 64 | 76 | NS | 3% of study population neutropenic; Microbiologic response higher with anidulafungin. |
|
Fluconazole | 118 | 87 | 59 | 60 | ||||
Pappas 2007[128] | Caspofungin | 188 | 86 | 44 | 72 | NS | 9% of study population neutropenic | |
Micafungin 100mg | 191 | 85 | 48 | 76 | ||||
Micafungin 150 mg | 199 | 84 | 51 | 71 |
NS, not significant; LAMB, liposomal amphotericin B; AmB, amphotericin B; SAEs, serious adverse events
Modified intent to treat population