{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T18:22:53Z","timestamp":1788718973431,"version":"build-2803163510"},"reference-count":64,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2023,5,18]],"date-time":"2023-05-18T00:00:00Z","timestamp":1684368000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["APMIS"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:p>This review assessed the effectiveness of fluconazole as antifungal prophylaxis on the incidence of oral fungal diseases in patients undergoing cancer treatment. The secondary outcomes evaluated were the adverse effects, discontinuation of cancer therapy due to oral fungal infection, mortality by a fungal infection, and the mean duration of antifungal prophylaxis. Twelve databases and records were searched. The RoB 2 and ROBINS I tools were used to assess the risk of bias. The relative risk (RR), risk difference, and standard mean difference (SMD) were applied with 95% confidence intervals (CI). The certainty of the evidence was determined by GRADE. Twenty\u2010four studies were included in this systematic review. In randomized controlled trials pooling, fluconazole was a protective factor for the primary outcome (RR\u2009=\u20090.30; CI: 0.16, 0.55; p\u2009&lt;\u20090.01, vs placebo). Compared to other antifungals, fluconazole was only more effective than the subgroup of amphotericin B and nystatin (alone or in combination) (RR\u2009=\u20090.19; CI: 0.09, 0.43; p\u2009&lt;\u20090.01). Fluconazole was also a protective factor in non\u2010randomized trials pooling (RR\u2009=\u20090.19; CI: 0.05, 0.78; p\u2009=\u20090.02, vs untreated). The results showed no significant differences for the secondary outcomes. The certainty of the evidence was low and very low. In conclusion, prophylactic antifungals are necessary during cancer treatment, and fluconazole was shown to be more effective in reducing oral fungal diseases only compared with the subgroup assessing amphotericin B and nystatin, administered alone or in combination.<\/jats:p>","DOI":"10.1111\/apm.13324","type":"journal-article","created":{"date-parts":[[2023,5,18]],"date-time":"2023-05-18T10:29:37Z","timestamp":1684405777000},"page":"668-684","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Effectiveness of fluconazole as antifungal prophylaxis in cancer patients undergoing chemotherapy, radiotherapy, or immunotherapy: systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5574-1119","authenticated-orcid":false,"given":"Wilmer","family":"Ram\u00edrez\u2010Carmona","sequence":"first","affiliation":[{"name":"Department of Preventive and Restorative Dentistry, School of Dentistry, Ara\u00e7atuba S\u00e3o Paulo State University (Unesp)  Ara\u00e7atuba\/S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6622-8572","authenticated-orcid":false,"given":"Gabriela Leal Peres","family":"Fernandes","sequence":"additional","affiliation":[{"name":"Department of Preventive and Restorative Dentistry, School of Dentistry, Ara\u00e7atuba S\u00e3o Paulo State University (Unesp)  Ara\u00e7atuba\/S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9349-7033","authenticated-orcid":false,"given":"Beatriz","family":"D\u00edaz\u2010Fabregat","sequence":"additional","affiliation":[{"name":"Department of Preventive and Restorative Dentistry, School of Dentistry, Ara\u00e7atuba S\u00e3o Paulo State University (Unesp)  Ara\u00e7atuba\/S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9823-8241","authenticated-orcid":false,"given":"Evelyn Carmo","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Department of Preventive and Restorative Dentistry, School of Dentistry, Ara\u00e7atuba S\u00e3o Paulo State University (Unesp)  Ara\u00e7atuba\/S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5897-2799","authenticated-orcid":false,"given":"Rosana Leal","family":"do Prado","sequence":"additional","affiliation":[{"name":"School of Dentistry, Presidente Prudente University of Western S\u00e3o Paulo (UNOESTE)  Presidente Prudente\/S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1550-3933","authenticated-orcid":false,"given":"Juliano Pelim","family":"Pessan","sequence":"additional","affiliation":[{"name":"Department of Preventive and Restorative Dentistry, School of Dentistry, Ara\u00e7atuba S\u00e3o Paulo State University (Unesp)  Ara\u00e7atuba\/S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5229-5259","authenticated-orcid":false,"given":"Douglas Roberto","family":"Monteiro","sequence":"additional","affiliation":[{"name":"Department of Preventive and Restorative Dentistry, School of Dentistry, Ara\u00e7atuba S\u00e3o Paulo State University (Unesp)  Ara\u00e7atuba\/S\u00e3o Paulo Brazil"},{"name":"School of Dentistry, Presidente Prudente University of Western S\u00e3o Paulo (UNOESTE)  Presidente Prudente\/S\u00e3o Paulo Brazil"},{"name":"Postgraduate Program in Health Sciences University of Western S\u00e3o Paulo (UNOESTE)  Presidente Prudente\/S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,5,18]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21660"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.archoralbio.2019.104480"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/pmj.78.922.455"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520\u2010010\u20100892\u2010z"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.7860\/JCDR\/2016\/15702.7180"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/odi.13151"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.archoralbio.2020.104906"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520\u2010019\u201005084\u20106"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2015.01391"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1439\u20100507.1998.tb00364.x"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1086\/313654"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/odi.13588"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciab591"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i4919"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471\u20102288\u201014\u2010135"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/icvts\/ivy163"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.archoralbio.2022.105432"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0895\u20104356(00)00242\u20100"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.328.7454.1490"},{"issue":"3","key":"e_1_2_9_22_1","first-page":"24","article-title":"Prophylaxis of candidiasis in cancer patients","volume":"17","author":"Bodey GP","year":"1990","journal-title":"Semin Oncol"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/33.2.309"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102354.2007.00855.x"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02026116"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/40.6.855"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.52.5.376"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003\u20104819\u2010120\u201011\u2010199406010\u201000003"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01974614"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/31.6.973"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/27.3.369"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1093\/clinids\/12.supplement_3.s369"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/172.4.1035"},{"key":"e_1_2_9_34_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003\u20104819\u2010118\u20107\u2010199304010\u201000003"},{"key":"e_1_2_9_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0002\u20109343(99)00457\u2010x"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0959\u20108049(99)00102\u20101"},{"key":"e_1_2_9_37_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF03259575"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1093\/jjco\/hyg017"},{"key":"e_1_2_9_39_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520\u2010005\u20100835\u20102"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.prro.2012.05.008"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00365855"},{"key":"e_1_2_9_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/s1079\u20102104(96)80328\u20103"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365\u20102141.1999.01465.x"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1439-0507.1997.tb00542.x"},{"key":"e_1_2_9_45_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.surge.2021.01.006"},{"key":"e_1_2_9_46_1","volume-title":"LiverTox: clinical and research information on drug\u2010induced liver injury [Internet]","year":"2012"},{"key":"e_1_2_9_47_1","volume-title":"StatPearls [Internet]","author":"Govindarajan A","year":"2022"},{"key":"e_1_2_9_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.archoralbio.2011.04.006"},{"key":"e_1_2_9_49_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13046\u2010020\u201001715\u20107"},{"key":"e_1_2_9_50_1","doi-asserted-by":"publisher","DOI":"10.14694\/EdBook_AM.2013.33.e236"},{"key":"e_1_2_9_51_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520\u2010019\u201004893\u2010z"},{"key":"e_1_2_9_52_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2019.05.013"},{"key":"e_1_2_9_53_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrc1318"},{"key":"e_1_2_9_54_1","doi-asserted-by":"publisher","DOI":"10.3390\/medicina55020025"},{"key":"e_1_2_9_55_1","doi-asserted-by":"publisher","DOI":"10.3390\/ph13060121"},{"key":"e_1_2_9_56_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbrc.2019.08.053"},{"key":"e_1_2_9_57_1","doi-asserted-by":"publisher","DOI":"10.1093\/mmy\/myv047"},{"key":"e_1_2_9_58_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00735\u201007"},{"key":"e_1_2_9_59_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkz425"},{"key":"e_1_2_9_60_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01292\u201020"},{"key":"e_1_2_9_61_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkp507"},{"key":"e_1_2_9_62_1","doi-asserted-by":"publisher","DOI":"10.1155\/2022\/4584846"},{"key":"e_1_2_9_63_1","doi-asserted-by":"publisher","DOI":"10.2174\/1389557520666200628032116"},{"key":"e_1_2_9_64_1","doi-asserted-by":"publisher","DOI":"10.2217\/fmb\u20102022\u20100138"},{"key":"e_1_2_9_65_1","doi-asserted-by":"publisher","DOI":"10.2217\/fmb\u20102019\u20100182"}],"container-title":["APMIS"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/apm.13324","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,12]],"date-time":"2023-10-12T02:57:05Z","timestamp":1697079425000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/apm.13324"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,18]]},"references-count":64,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2023,11]]}},"alternative-id":["10.1111\/apm.13324"],"URL":"https:\/\/doi.org\/10.1111\/apm.13324","archive":["Portico"],"relation":{},"ISSN":["0903-4641","1600-0463"],"issn-type":[{"value":"0903-4641","type":"print"},{"value":"1600-0463","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5,18]]},"assertion":[{"value":"2023-04-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-04-18","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-05-18","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}