caa a22 4500 606157085 CHVBK 20210128100611.0 cr unu---uuuuu 210128e20150401xx s 000 0 eng 10.1007/s10096-014-2287-4 doi (NATIONALLICENCE)springer-10.1007/s10096-014-2287-4 Efficacy and safety of echinocandins versus triazoles for the prophylaxis and treatment of fungal infections: a meta-analysis of RCTs [Elektronische Daten] [J.-F. Wang, Y. Xue, X.-B. Zhu, H. Fan] Echinocandins and triazoles were proven to be effective antifungal drugs against invasive fungal infections (IFI), which may cause significant morbidity and mortality in immunocompromised patients. The aim of this study was to compare the efficacy and safety between echinocandins and triazoles for the prophylaxis and treatment of fungal infections. PubMed, Embase, and the Cochrane Library were searched to identify relevant randomized controlled trials (RCTs) up to July 2014. The quality of trials was assessed with the Jadad scoring system. The primary outcomes of interest were treatment success, microbiological success, breakthrough infection, drug-related adverse events (AEs), withdrawals due to AEs, and all-cause mortality. Ten RCTs, involving 2,837 patients, were included, as follows: caspofungin versus fluconazole (n = 1), caspofungin versus itraconazole (n = 1), anidulafungin versus fluconazole (n = 1), micafungin versus fluconazole (n = 4), micafungin versus voriconazole (n = 2), and micafungin versus itraconazole (n = 1). Echinocandins and triazoles showed similar effects in terms of favorable treatment success rate [relative risk (RR) = 1.02, 95% confidence interval (CI), 0.97-1.08], microbiological success rate (RR = 0.98, 95% CI, 0.90-1.15), breakthrough infection (RR = 1.09; 95% CI, 0.59-2.01), drug-related AEs (RR = 0.94; 95% CI, 0.71-1.15), and all-cause mortality (RR = 0.85; 95% CI, 0.66-1.10) in the prophylaxis and treatment of fungal infections. Additionally, echinocandins were more effective than triazoles for prophylaxis in patients undergoing hematologic malignancies or those who received hematopoietic stem cell transplantation (HSCT; RR = 1.08; 95% CI, 1.02-1.15). Echinocandins significantly decreased the AE-related withdrawals rate compared with triazoles (RR = 0.47; 95% CI, 0.33-0.67). This meta-analysis revealed that echinocandins are as effective and safe as triazoles for the prophylaxis and treatment of patients with fungal infections. The Author(s), 2014 Wang J.-F Department of Pharmacy, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, 3 East Qingchun Road, 310016, Hangzhou, Zhejiang, People's Republic of China aut Xue Y. Department of Pharmacy, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, 3 East Qingchun Road, 310016, Hangzhou, Zhejiang, People's Republic of China aut Zhu X.-B Department of Pharmacy, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, 3 East Qingchun Road, 310016, Hangzhou, Zhejiang, People's Republic of China aut Fan H. Department of Pharmacy, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, 3 East Qingchun Road, 310016, Hangzhou, Zhejiang, People's Republic of China aut European Journal of Clinical Microbiology & Infectious Diseases Springer Berlin Heidelberg 34/4(2015-04-01), 651-659 0934-9723 34:4<651 2015 34 10096 https://doi.org/10.1007/s10096-014-2287-4 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 review-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10096-014-2287-4 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Wang J.-F Department of Pharmacy, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, 3 East Qingchun Road, 310016, Hangzhou, Zhejiang, People's Republic of China aut NATIONALLICENCE 700 1- Xue Y. Department of Pharmacy, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, 3 East Qingchun Road, 310016, Hangzhou, Zhejiang, People's Republic of China aut NATIONALLICENCE 700 1- Zhu X.-B Department of Pharmacy, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, 3 East Qingchun Road, 310016, Hangzhou, Zhejiang, People's Republic of China aut NATIONALLICENCE 700 1- Fan H. Department of Pharmacy, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, 3 East Qingchun Road, 310016, Hangzhou, Zhejiang, People's Republic of China aut NATIONALLICENCE 773 0- European Journal of Clinical Microbiology & Infectious Diseases Springer Berlin Heidelberg 34/4(2015-04-01), 651-659 0934-9723 34:4<651 2015 34 10096