Abstract | BACKGROUND: Antifungal prophylaxis to prevent invasive fungal infections (IFI) is widely used following lung transplantation, but the optimal strategy remains unclear. We compared universal with targeted antifungal prophylaxis for effectiveness in preventing IFI. METHODS: RESULTS: Of 105 lung transplant recipients, 84 (80%) received a double lung transplant, and 38 (36%) of patients underwent transplant for pulmonary fibrosis. Fifty-nine (56%) patients received universal antifungal prophylaxis, and 46 (44%), targeted antifungal prophylaxis. Among 20 proven/probable IFI, there were 14 IPA, 4 invasive candidiasis, 1 cryptococcosis, and 1 deep sternal mold infection. Six (10%) IFI occurred in the universal prophylaxis cohort and 14 (30%) in the targeted prophylaxis cohort. Five of 6 (83%) IFI in the universal prophylaxis cohort, compared with 9/14 (64%) in the targeted prophylaxis cohort, were IPA Candida infections occurred only in the targeted prophylaxis cohort. The development of IFI was more likely in the targeted prophylaxis cohort than the universal prophylaxis cohort, HR = 4.32 (1.51-12.38), P = .0064. CONCLUSIONS: Universal antifungal prophylaxis appears to be more effective than targeted antifungal prophylaxis for prevention of IFI after lung transplant.
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Authors | Kathleen A Linder, Carol A Kauffman, Twisha S Patel, Linda J Fitzgerald, Blair J Richards, Marisa H Miceli |
Journal | Transplant infectious disease : an official journal of the Transplantation Society
(Transpl Infect Dis)
Vol. 23
Issue 1
Pg. e13448
(Feb 2021)
ISSN: 1399-3062 [Electronic] Denmark |
PMID | 33448560
(Publication Type: Journal Article)
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Copyright | © 2020 Wiley Periodicals LLC. |
Chemical References |
- Antifungal Agents
- Fluconazole
- Micafungin
|
Topics |
- Antifungal Agents
(therapeutic use)
- Fluconazole
- Humans
- Invasive Fungal Infections
(drug therapy)
- Lung Transplantation
- Micafungin
|