Fluconazole for Antifungal Therapy in Cancer Patients
Author Information
Author(s): Yu Donghui T, Diane L Seger, Josh F Peterson, Ritesh N Kumar, David W Bates
Primary Institution: Brigham and Women's Hospital, Boston, MA, USA
Hypothesis
What is the frequency and resource utilization associated with treatment failure in cancer patients given empiric fluconazole antifungal therapy?
Conclusion
Treatment failure occurred in more than one-third of neutropenic cancer patients on fluconazole as empiric antifungal treatment for fever in routine clinical treatment.
Supporting Evidence
- 41% of cancer admissions experienced treatment failure after initiating fluconazole.
- Patients with hematological malignancies had a 4.6 times higher risk of treatment failure.
- The mean increase in length of stay due to treatment failure was 7.4 days.
- The mean increase in total costs associated with treatment failure was $18,925.
Takeaway
Many cancer patients with fever and low white blood cell counts didn't get better on fluconazole, a common antifungal medicine, and this made their hospital stay longer and more expensive.
Methodology
Retrospective cohort study of cancer patients treated with fluconazole between 1997 and 2001.
Potential Biases
Potential bias due to retrospective design and reliance on chart documentation.
Limitations
The study relied on patient chart documentation, which may have missed undocumented adverse effects, and was conducted at a single tertiary care hospital.
Participant Demographics
Mean age 51 years, 60% female, 95% white, 76.7% had hematological malignancies.
Statistical Information
P-Value
0.001
Confidence Interval
95% CI 31% – 50%
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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