Anidulafungin versus Fluconazole for Invasive Candidiasis

Abstract

Anidulafungin was shown to be noninferior to fluconazole in the treatment of invasive candidiasis. (ClinicalTrials.gov number, NCT00056368 [ClinicalTrials.gov]).

Fungicidal versus fungistatic therapy of invasive Candida infection in non-neutropenic adults: a meta-analysis

“…In another study, only non-neutropenic (post-surgery) subjects appear to have been enrolled although an absence of neutropenia was not an explicit study requirement (Kujath et al 1993). There were 2.5% patients with neutropenia in the remaining study (Reboli et al 2007). This was the only study in which the fungicidal arm was represented by an echinocandin.…”

“…A total of 1335 eligible subjects were enrolled in the eight included trials (Kujath et al 1993; Rex et al 1994, 2003; Abele-Horn et al 1996; Anaissie et al 1996; Phillips et al 1997; Kullberg et al 2005; Reboli et al 2007) (Table 2). All of the studies were published in peer-reviewed, English-language journals between 1993 and 2014.…”

“…Of the eight studies, half enrolled more than 100 eligible patients (Rex et al 1994, 2003; Kullberg et al 2005; Reboli et al 2007) and 6 were multicentre (Rex et al 1994, 2003; Anaissie et al 1996; Phillips et al 1997; Kullberg et al 2005; Reboli et al 2007). Although all studies were randomised, only two claimed blinding through the study (Rex et al 2003; Reboli et al 2007). In two cases, the study was blinded at initial randomisation but not during the entire course of the study (Rex et al 1994; Kullberg et al 2005) (Table 1).…”

“…The others enrolled adults and older children with the study by Kullberg et al (2005) enrolling children as young as 12. Candidemia was the enrolment criterion in four of the trials (Rex et al 1994, 2003; Phillips et al 1997; Kullberg et al 2005); the others allowed entry on the basis of invasive candidiasis without documented candidemia (Kujath et al 1993; Abele-Horn et al 1996; Anaissie et al 1996; Reboli et al 2007). Five of the studies specifically excluded neutropenic subjects (Rex et al 1994, 2003; Abele-Horn et al 1996; Phillips et al 1997; Kullberg et al 2005).…”

“…In seven trials, the fungistatic therapy utilised was fluconazole (Kujath et al 1993; Rex et al 1994, 2003; Abele-Horn et al 1996; Anaissie et al 1996; Phillips et al 1997; Reboli et al 2007); the remaining study utilised voriconazole (Kullberg et al 2005). Seven of the eight studies used standard amphotericin B deoxycholate as the fungicidal therapy (Kujath et al 1993; Rex et al 1994, 2003; Abele-Horn et al 1996; Anaissie et al 1996; Phillips et al 1997; Kullberg et al 2005); the other study used the echinocandin, anidulafungin (Reboli et al 2007).…”