Abstract
We evaluated the efficacy and toxicity of ketoconazole versus nystatin antimycotic prophylaxis in a prospective randomized study of 32 patients receiving intensive weekly outpatient combination chemotherapy for non-Hodgkin's lymphoma with crossover to the other drug if failure occurred. Thirteen patients were assigned to nystatin and 19 to ketoconazole. Fungal infections occurred in three patients receiving nystatin (16%) and one patient receiving ketoconazole (8%); one patient refused his assigned drug due to taste intolerance. Including the crossover courses of drug, the failure rate associated with ketoconazole was 6% while that for nystatin was 20% (p = 0.23). We favor ketoconazole as antifungal prophylaxis during antilymphoma chemotherapy because of at least equivalent and possibly superior efficacy, better acceptance by patients, easier administration, and systemic absorption.
Publication types
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Clinical Trial
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Comparative Study
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Randomized Controlled Trial
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Research Support, Non-U.S. Gov't
MeSH terms
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Aged
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Antineoplastic Combined Chemotherapy Protocols*
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Bleomycin / therapeutic use
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Clinical Trials as Topic
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Cyclophosphamide / therapeutic use
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Doxorubicin / therapeutic use
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Female
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Humans
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Ketoconazole / administration & dosage
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Ketoconazole / adverse effects
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Ketoconazole / therapeutic use*
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Leucovorin / therapeutic use
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Lymphoma, Non-Hodgkin / complications*
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Lymphoma, Non-Hodgkin / drug therapy
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Male
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Methotrexate / therapeutic use
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Middle Aged
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Mycoses / prevention & control*
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Nystatin / administration & dosage
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Nystatin / adverse effects
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Nystatin / therapeutic use*
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Prednisone / therapeutic use
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Prospective Studies
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Random Allocation
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Time Factors
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Vincristine / therapeutic use
Substances
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Bleomycin
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Nystatin
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Vincristine
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Doxorubicin
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Cyclophosphamide
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Leucovorin
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Ketoconazole
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Prednisone
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Methotrexate