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March 1984

Efficacy of Ketoconazole v Nystatin in Prevention of Fungal Infections in Neutropenic Patients

Author Affiliations

From the Divisions of Infectious Diseases and Hematology-Oncology, the Department of Internal Medicine, University of Michigan Medical School and Veterans Administration Medical Center, Ann Arbor. Dr Jones is currently affiliated with the Division of Infectious Diseases, M.D. Anderson Hospital, Houston; Dr McAuliffe is currently affiliated with East Main Street Medical Associates, Hyannis, Mass; and Dr Liepman is currently affiliated with the Division of Medical Oncology, University of Massachusetts Medical School, Worcester.

Arch Intern Med. 1984;144(3):549-551. doi:10.1001/archinte.1984.00350150149034

• A prospective randomized study was undertaken in neutropenic patients to evaluate the efficacy of prophylactic ketoconazole v nystatin in reducing yeast infections. Eighteen patients received 500,000 units of nystatin suspension four times daily, and 18 patients received 200 mg of ketoconazole daily. The nystatin group experienced nine local yeast infections (four thrush, three esophagitis, and two vaginitis); three patients receiving ketoconazole had thrush. No cases of disseminated candidiasis occurred in either group. Ketoconazole was better tolerated than nystatin and neither drug caused toxic effects. In addition to being nontoxic and better tolerated, ketoconazole appeared to be slightly more effective than nystatin in reducing locally severe yeast infections.

(Arch Intern Med 1984;144:549-551)

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