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BIS. Boletim do Instituto de Saúde (Impresso)

versión impresa ISSN 1518-1812

Resumen

ANDREA MOLINA LIMA, Silvana; RUBEN DE A. BONFIM, José; RACHED CAMPOS, Eneida  y  NASCIMENTO, Andréia. Voriconazole and caspofungin versus amphotericin in the treatment of aspergillosis in high-risk patients: hematologic malignancies, febrile neutropenia or undergoing transplantation in general. BIS, Bol. Inst. Saúde (Impr.) [online]. 2013, vol.14, n.2, pp. 205-212. ISSN 1518-1812.

Background: Amphotericin B is the antifungal agent used in the Brazilian Public Health System (SUS) for the treatment of invasive fungal infection (IFI). New antifungal agents are being selected with little epidemiological definition and high cost. Objective: To conduct health technology assessment on the safety and efficacy of voriconazole (VOR) and Caspofungin (CAS) versus Amphotericin (AmB) in the treatment of aspergillosis in high-risk patients: hematologic malignancies, febrile neutropenia or undergoing transplantation in general. Methods: It was conducted searches of articles in Trip Database, PubMed, LILACS and Cochrane. The words used were voriconazole, caspofungin, amphotericin, aspergillus and fusarium. Outcomes: survival, response to therapy and discontinuation of treatment. Results: The primary analysis considered 3 systematic reviews and 4 clinical trials. The auxiliary analysis considered 6 articles (2 observational studies and 4 economic evaluations), 2 guidelines and 2 editorial articles. Conclusion: The VOR and CAS are not inferior to AmB. There is evidence of superiority of these two drugs in some specific conditions. It’s essential new diagnostic techniques for early and specific treatment decision for patients with IFI, because there is greater efficacy and safety in the use of antifungal agents in patients with proven infection.

Palabras llave : Voriconazole; Caspofungin; Amphotericin B.

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