Echinocandin use in lung transplant recipients.

Abstract:

BACKGROUND:Invasive fungal infections (IFI) are associated with significant morbidity and mortality in lung transplant recipients (LTRs). However, data outlining use of echinocandins in prophylaxis and therapy of LTRs are limited. METHOD:A single-center retrospective cohort study on all LTRs from January-2010 to December-2016. Participants were screened for antifungal use to assess rate, tolerability, and clinical outcome of echinocandin use in LTRs, during the first 6 weeks of posttransplant. RESULTS:A total of 777 lung transplants were reviewed in 763 LTRs. Antifungals were administered to 268 (35%) of LTRs. Reasons included preemptive antifungal therapy (55% [149/268]), targeted antifungal prophylaxis (34% [92/268]), and definitive IFI therapy (10% [27/268]). Azoles were first-line agents in 80% (215/268) of LTRs, caspofungin in 11% (30/268), micafungin in 6.7% (18/268), amphotericin B in 1.5% (4/268), and anidulafungin in 0.4% (1/268]). LTRs were started on echinocandins due to abnormal liver enzymes in 91% (46/49). Overall, 23% (50/215) of LTR's were switched off azoles. Of these, 54% (27/50) were switched to echinocandins. Switch from azoles to echinocandin was undertaken due to abnormal liver enzymes in 63% (17/27). No patients receiving first-line echinocandins were switched to other therapies due to adverse events. CONCLUSIONS:Our data suggest that echinocandins are utilized in approximately 18.3% of lung transplant recipients. They are the preferred second-line agents due to a lower adverse-effect profile compared to the azoles.

journal_name

Clin Transplant

journal_title

Clinical transplantation

authors

Al Jishi Y,Rotstein C,Kumar D,Humar A,Singer LG,Keshavjee S,Husain S

doi

10.1111/ctr.13437

subject

Has Abstract

pub_date

2018-12-01 00:00:00

pages

e13437

issue

12

eissn

0902-0063

issn

1399-0012

journal_volume

32

pub_type

临床试验,杂志文章
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    doi:

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    pub_type: 杂志文章,多中心研究,随机对照试验

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    pub_type: 临床试验,杂志文章

    doi:

    authors: Matas AJ,Gores PF,Kelley SL,Bielefield-Skrokov M,Kinaszczuk M,Gruessner RW,Najarian JS

    更新日期:1994-04-01 00:00:00

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    authors: Nerlekar N,Mulley W,Rehmani H,Ramkumar S,Cheng K,Vasanthakumar SA,Rashid H,Barton T,Nasis A,Meredith IT,Moir S,Mottram PM

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