TABLE 24.

Meta-analysis of antifungal prophylaxis in nonneutropenic critically ill and surgical patients: comparison of five recent systematic reviews

Authors (reference)No. of studies includedaTotal no. of patientsPatient typeYrAntifungal agent(s)b (no. of studies)Effects of prophylaxis onc:
IFIMortalityResistance
Playford et al. (233)121,606ICU, surgical1987-2003FLC (8), KTC (4)Decreased by 50%*Decreased by 25%*No increase
Vardakas et al. (295)7941SICU1987-2003FLC (5), KTC (1), ITC (1)Decreased by 75%†Decreased by 25%†No increase
Cruciani et al. (45)91,226SICU1987-2003FLC (6), KTC (3)Decreased by 80%†Decreased by 79%†NA
Ho et al. (103)7814High-risk surgical1999-2003FLCDecreased by 79%†No decrease†NA
Shorr et al. (270)4626SICU1999-2002FLCDecreased by 55%†No decrease†No increase
  • a Number of studies included in the meta-analysis.

  • b FLC, fluconazole; KTC, ketoconazole; ITC, itraconazole.

  • c IFI, invasive fungal infection; NA, not assessed; *, refers to IFI due to any fungal pathogen; †, refers to IFI due to Candida only. Results for mortality are for mortality due to IFI; results for resistance refer to superinfection or colonization with fungi resistant to the agent used for prophylaxis.