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Volume 357:1347-1348 September 27, 2007 Number 13
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Anidulafungin and Fluconazole for Candidiasis

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by Reboli, A. C.
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To the Editor: The study of anidulafungin as compared with fluconazole for invasive candidiasis by Reboli et al. (June 14 issue)1 shows the challenges involved in the design and reporting of noninferiority trials.2,3 First, the dose of fluconazole may have been inadequate.4,5 Second, no justification is provided for the conspicuously large prestated margin of noninferiority used in this trial, even though justification is recommended.6 This prestated margin of noninferiority implies that a difference in treatment effect of less than 20 percentage points is clinically negligible, a contention that few reasonable clinicians would support, especially given the lack of other advantages . . . [Full Text of this Article]



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