Effectiveness of Prophylactic Fluconazole at Low Doses for Allogeneic Hematopoietic Stem Cell Transplant Patients

Abstract

Objectives: The purpose of this study was to evaluate if fluconazole 200 mg is an acceptable alternative to the fluconazole 400 mg for fungal prophylaxis in allogenic hematopoietic stem cell patients. Lower fluconazole doses will decrease cost of therapy and may reduce adverse events associated with higher doses. Methods: This study was a retrospective chart review conducted at the Arizona Cancer Center. A total of 58 patients qualified for the study. Primary endpoints were number of days on fluconazole 200 mg and type and number of fungal infections that occurred within 1 year post transplant. Results: Out of the fifty-eight patients who qualified for the study, only eight patients had a breakthrough fungal infection while on 200 mg (13.7%) after one year. Three of those eight were identified as having systemic fungal infections (5.2%). Conclusions: Fluconazole 200 mg is a reasonable low-cost and low side effect alternative to fluconazole 400 mg for antifungal prophylaxis in allogenic hematopoietic stem cell patients.