泊沙康唑
伏立康唑
医学
中性粒细胞减少症
内科学
不利影响
入射(几何)
外科
抗真菌
化疗
皮肤病科
物理
光学
作者
Reem Almutairy,Reem Almutairy,Reem Almutairy,Reem Almutairy,Mansoor Ahmed Khan,Mansoor Ahmed Khan,Alaa Shahbar,Mohammed Aseeri,Mohammed Aseeri,Majed Alshamrani,Hassan Almarhabi,Hassan Almarhabi,Hassan Almarhabi,Hassan Almarhabi,Doaa Naeem
标识
DOI:10.1177/10781552241246119
摘要
Introduction The incidence of invasive fungal diseases (IFDs) has risen in hematologic malignancy patients due to neutropenia. While posaconazole is recommended as the first-line antifungal prophylaxis in acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS) patients and voriconazole is an alternative, there is currently no direct comparison data available to assess their relative effectiveness. Method We retrospectively reviewed eligible patient charts from January 2017 to February 2019 to identify breakthrough IFD rates, drug adverse event frequency, and drug acquisition cost in AML/MDS patients. Results Forty-eight patients received 130 chemo cycles, with 50 (38%) cycles prescribed posaconazole and 80 (62%) prescribed voriconazole as primary IFD prophylaxis. The incidence rates of IFD in the posaconazole group were 8% (4 out of 50), of which two were probable and two were possible infections, while 6.26% (5 out of 80) of patients in the voriconazole group developed IFD, with four possible infections and one probable infection ( p = 0.73). A higher percentage of patients in the voriconazole group discontinued prophylaxis due to adverse events, with six patients compared to two patients in the posaconazole group ( p = 0.15). The drug acquisition cost of posaconazole is 5.62 times more expensive than voriconazole. Conclusion The use of voriconazole instead of posaconazole for 130 chemo cycles would save $166,584.6. Posaconazole and voriconazole have comparable efficacy and safety in preventing IFD in AML and MDS patients receiving chemotherapy. However, posaconazole is more costly than voriconazole.
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