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Table 3.6 Selected clinical trials conducted on licensed antifungals
| Antifungal prophylaxis | Neutropenic fever | Invasive aspergillosis | Candidaemia or invasive candidiasis | Oesophageal candidiasis |
|---|---|---|---|---|
| Voriconazole vs. placebo (182) | Micafungin vs caspofungin (183) | Posaconazole vs liposomal amphotericin B ± caspofungin (184) | Caspofungin vs amphotericin B (172); Caspofungin vs amphotericin B in newborn infants (185) |
Caspofungin vs amphotericin B (186–187) |
| Micafungin vs fluconazole (188); Micafungin vs fluconazole (189); Micafungin vs fluconazole, liposomal amphotericin B or caspofungin post-liver-transplant (190) |
Caspofungin vs liposomal amphotericin B (191); Caspofungin vs liposomal amphotericin B (192) | Voriconazole vs amphotericin B (173,193) | Caspofungin (standard vs high dose) (194) | Caspofungin vs fluconazole (195) |
| Itraconazole vs fluconazole (196–197) | Voriconazole vs liposomal amphotericin B (198) | Liposomal amphotericin B (standard dose vs high loading dose)(199) | Anidulafungin vs fluconazole (200); Anidulafungin vs fluconazole in critically ill (201) |
Anidulafungin vs fluconazole (202) |
| Posaconazole vs fluconazole or itraconazole (203–205) | Itraconazole vs amphotericin B (206–207) | Isavuconazole vs voriconazole (for invasive mould disease) (208) | Micafungin vs caspofungin (177) | Micafungin vs fluconazole (209–210) |
| Voriconazole/ posaconazole vs fluconazole/ itraconazole in AML/MDS undergoing chemotherapy (211); Voriconazole vs itraconazole in post allogeneic HSCT (212); Voriconazole vs fluconazole in post allogeneic HSCT (213) |
Different amphotericin B formulations (214–215) | Voriconazole and anidulafungin vs voriconazole monotherapy (216) | Micafungin vs liposomal amphotericin B (217–219) | Voriconazole vs fluconazole (220) |
| Aerosolized liposomal amphotericin B vs placebo inhalation (221) | Micafungin vs itraconazole (222) | Voriconazole vs amphotericin B followed by fluconazole (223) | Isavuconazole vs fluconazole (224) | |
| Voriconazole vs low dose amphotericin B in paediatric acute leukaemia induction (225) | Immediate voriconazole vs deferred placebo (226) | Micafungin vs voriconazole in kidney transplant recipients (227) | ||
| Anidulafungin vs fluconazole in high-risk liver transplant patients (228) | Preemptive micafungin following gastrointestinal surgery (229) | |||
| Caspofungin prophylaxis followed by preemptive therapy for invasive candidiasis (230) | Caspofungin vs micafungin (231) |
Note:
AML, acute myelogenous leukaemia
HSCT, haematopoietic stem cell transplantation
MDS, myelodysplastic syndromes
Agent with superior results for some outcomes is underlined.
