Efficacy and safety study of posaconazole and voriconazole for the prevention of invasive fungal infections after allogeneic hematopoietic stem cell transplantation
Online published: 2023-03-25
目的 比较泊沙康唑与伏立康唑预防异基因造血干细胞移植(allo⁃HSCT)后侵袭性真菌感 染(IFI)的疗效及安全性差异。方法 回顾性分析 2019 年 6 月⁃2021 年 6 月于我院行 allo⁃HSCT 且应用泊沙 康唑或伏立康唑进行真菌预防的 104 例患者(泊沙康唑组 54 例,伏立康唑组 50 例),对比两组移植后 180 d 内 IFI 发生率、药物不良反应发生率等相关指标。结果 泊沙康唑组和伏立康唑组 IFI 发生率分别为 7.4% (4 例)和 20.0%(10 例),差异无统计学意义(P = 0.085);在 IFI 高危风险的患者中,两组 IFI 发生率为 10.0% (3 例)和 34.9%(9 例),差异有统计学意义(P = 0.047);两组药物不良反应发生率为 7.4%(4 例)和 18.0% (9 例),差异无统计学意义(P = 0.091)。结论 泊沙康唑较伏立康唑可进一步降低 allo⁃HSCT 后高危风险 患者的IFI 发生率,且未增加药物相关不良反应发生率。
关键词:
异基因造血干细胞移植
彭英楠 边志磊 曹伟杰 李丽 张素平 万鼎铭 . 泊沙康唑与伏立康唑预防异基因造血干细胞移植后侵袭性真菌感染的疗效和安全性 [J]. 实用医学杂志, 2023 , 39(6) : 742 -746 . DOI: 10.3969/j.issn.1006⁃5725.2023.06.015
Objective To compare the clinical efficacy and safety differences between posaconazole and voriconazole for the prevention of fungal infections after allogeneic hematopoietic stem cell transplantation(allo ⁃ HSCT). Methods Retrospective analysis of 104 patients(54 in the posaconazole group and 50 in the voricon⁃ azole group)who underwent allo ⁃ HSCT and applied posaconazole or voriconazole for fungal prophylaxis at our hospital from June 2019 to June 2021,comparing the incidence of IFI,the incidence of adverse drug reactions and other related indicators within 180 days after transplantation between the two groups. Results The incidence of IFI in the posaconazole and voriconazole groups was 7.4%(4 cases)and 20.0%(10 cases),respectively,with no statistical difference(P = 0.085);in patients at high risk of IFI,the incidence of IFI in the two groups was 10.0% (3 cases)and 34.9%(9 cases),with a statistical difference(P = 0.047);the incidence of adverse drug reactions in the two groups was 7.4%(4 cases)and 18.0%(9 cases),with no statistical difference(P = 0.091). Conclusion Compared with voriconazole,posaconazole can further reduce the incidence of IFD in high⁃risk patients after trans⁃ plantation without increasing the incidence of drug⁃related adverse reactions.
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