RT Journal Article
T1 Fluconazole versus micafungin for initial antifungal prophylaxis against Candida in pancreas transplant recipients: A comparative study of two consecutive periods.
A1 López Medrano, Francisco
A1 Muñoz de la Espada, M.
A1 Pérez-Jacoiste Asín, María Asunción
A1 Fernández Ruiz, Mario
A1 Herrero Martínez, Juan María
A1 Alonso-Carrillo, J.
A1 San Juan Garrido, Rafael
A1 Rodríguez Gonzer, Isabel
A1 Andrés Belmonte, Amado
A1 González Monte, Esther
A1 Manrique Municio, Alejandro
A1 Justo Alonso, Iago
A1 Marcacuzco Quinto, Alberto Alejandro
A1 Loinaz Segurola, Carmelo
A1 Jiménez, C.
A1 Lumbreras Bermejo, Carlos Juan
A1 Aguado García, José María
AB BackgroundInvasive fungal infection, particularly intraabdominal candidiasis, exerts a negative impact on the outcome of pancreas transplant recipients (PTRs). Optimal antifungal prophylaxis in this context remains unclear.MethodsWe performed a single-centre retrospective study to compare the incidence of invasive candidiasis during the first 6 post-transplant months in a cohort of 218 PTRs over two periods in which different agents for antifungal prophylaxis were used: fluconazole (Fluco-Px) from March 1995 to June 2012, and micafungin followed by fluconazole (Mica-Px) from July 2012 to December 2018.ResultsA total of 152 and 66 PTRs received Fluco-Px and Mica-Px. Mean age was 39.7 ± 7.8 years, 56.4% (123/218) were males, and 85.3% (186/218) underwent simultaneous pancreas–kidney transplantation. Invasive candidiasis occurred in 21.7% (33/152) of PTRs under Fluco-Px compared to 24.2% (16/66) of those under Mica-Px (p-value = .681). Median time from transplantation to infection was 8 days (interquartile range [IQR]: 6–16) under Fluco-Px versus 6.5 (IQR: 3.3–15.8) under Mica-Px (p-value = .623). Non-albicans Candida species comprised 27.5% (11/40) and 25.0% (4/16) of episodes under Fluco-Px and Mica-Px respectively (p-value = .849). Surgical site infection was the most common form in both groups (82.5% [33/40] and 87.5% [14/16]; p-value = .954). Multivariable analysis identified cold ischaemia time of the pancreas and kidney grafts, surgical reintervention and insulin requirement after transplantation as risks factor for invasive candidiasis.ConclusionThis retrospective study did not reveal a significant benefit from the initial use of micafungin-based antifungal prophylaxis over fluconazole among PTRs in terms of invasive candidiasis.
PB Wiley
YR 2022
FD 2022-05
LK https://hdl.handle.net/20.500.14352/129704
UL https://hdl.handle.net/20.500.14352/129704
LA eng
NO López‐Medrano, Francisco, et al. «Fluconazole versus Micafungin for Initial Antifungal Prophylaxis against Candida in Pancreas Transplant Recipients: A Comparative Study of Two Consecutive Periods». Mycoses, vol. 65, n.o 5, mayo de 2022, pp. 517-25.  https://doi.org/10.1111/myc.13436.
DS Docta Complutense
RD 20 ene 2026