Safety and efficacy of chronic suppressive azole therapy for endemic fungal infections in solid organ transplant recipients.
Transpl Infect Dis
; 20(5): e12963, 2018 Oct.
Article
em En
| MEDLINE
| ID: mdl-29975443
ABSTRACT
BACKGROUND:
Although the research is limited, treatment guidelines recommend lifelong suppressive azole therapy for disseminated endemic fungal infection (EFI) after solid organ transplantation (SOT). Suppressive azole therapy may prevent EFI recurrence at the risk of hepatotoxicity and drug interactions. We present real-world safety and effectiveness data of chronic suppressive azole therapy for EFI in SOT recipients over a 10-year period at a single comprehensive transplant center.METHODS:
A retrospective analysis was conducted of SOT recipients diagnosed with EFI from January 1, 2005, to May 1, 2015. Chronic suppressive azole therapy was defined as treatment for more than 12 months after diagnosis. Effectiveness of suppression was defined as preventing EFI reactivation. Safety endpoints included adverse reactions and drug interactions.RESULTS:
Over a 10-year period, 28 SOT recipients were diagnosed with EFI 16 histoplasmosis, 9 blastomycosis, and 3 coccidioidomycosis. Eighteen (64%) patients were treated with chronic suppressive azole therapy for a median length of 36 months (range 15-90). One patient had an adverse drug interaction requiring azole discontinuation. There were no episodes of azole-related hepatotoxicity, toxicity from antirejection medication, or EFI reactivation.CONCLUSIONS:
Chronic suppressive azole therapy was safe and effective in preventing reactivation of EFI in SOT recipients.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Transplante de Órgãos
/
Antibioticoprofilaxia
/
Doenças Endêmicas
/
Micoses
/
Antifúngicos
Tipo de estudo:
Guideline
/
Observational_studies
/
Risk_factors_studies
Limite:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
País como assunto:
America do norte
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article