Efficacy of different durations of antifungal prophylaxis with nebulized amphotericin B after lung transplantation: a retrospective cohort study

Ju, Chunrong1; Lian, Qiaoyan1; Wang, Xiaohua1; Wang, Lulin1; Zhang, Jianheng1; Cai, Yuhang1; Xu, Xin1; Chen, Rongchang2,3,5,6; He, Jianxing1,4

2023-09-01

10.21037/jtd-23-601

JOURNAL OF THORACIC DISEASE   Impact Factor & Quartile

2072-1439

2077-6624

Background: Nebulized amphotericin B (NAB) is recommended for preventing invasive fungal diseases (IFDs) after lung transplantation. However, the optimal duration of NAB treatment is still unknown. This study aimed to compare the effectiveness of three different durations of antifungal prophylaxis with NAB after lung transplantation: a prolonged course beyond post-transplant 3 months, a medium course of 2 weeks to 3 months, and a short course of less than 2 weeks.Methods: This a single-center retrospective cohort study analyzed 333 patients who underwent lung or heart-lung transplantation between January 2015 and November 2021.Results: A prolonged course of NAB treatment was associated with a significantly lower incidence of IFDs (12.6%) at 1 year post-transplant compared with a short (50.9%) or a medium course (28.0%) (P<0.001). There was no significant difference in the rates of adverse effects among the three durations of NAB treatment (P>0.05). A prolonged course of NAB treatment was associated with a significantly higher 1-year survival rate (94.7%) compared with a short (36.8%) or a medium course (72.0%) (P<0.001).Conclusions: A prolonged course of NAB treatment provided better protection against IFDs than a short or medium course after lung transplantation. Prolonged use of NAB did not significantly increase the incidence of adverse effects.

Aspergillosis invasive fungal infections lung transplantation nebulized amphotericin B (NAB) prophylaxis

SCI

English

Corresponding

State Key Laboratory of Respiratory Disease[SKLRHQN20205] ; Zhongnanshan Medical Foundation of Guangdong Province[ZNSA-2020013] ; Guangzhou Institute of Respiratory Health[2019GIRHZ04]

Respiratory System

Respiratory System

WOS:001081850600001

AME PUBLISHING COMPANY

Web of Science

1.Guangzhou Med Univ, Affiliated Hosp 1, Guangzhou Inst Resp Hlth, Natl Clin Res Ctr Resp Dis,State Key Lab Resp Dis, Guangzhou, Peoples R China
2.South Univ Sci & Technol, Affiliated Hosp 1, Shenzhen Peoples Hosp, Shenzhen Inst Resp Dis, Shenzhen, Peoples R China
3.Jinan Univ, Affiliated Hosp 2, Shenzhen, Peoples R China
4.Guangzhou Med Univ, Affiliated Hosp 1, Guangzhou Inst Resp Hlth, Natl Clin Res Ctr Resp Dis,State Key Lab Resp Dis, Yanjiang Rd, Guangzhou 510120, Peoples R China
5.South Univ Sci & Technol, Affiliated Hosp 1, Shenzhen Peoples Hosp, Shenzhen Inst Resp Dis, East Shennan Rd, Shenzhen 518020, Peoples R China
6.Jinan Univ, Affiliated Hosp 2, East Shennan Rd, Shenzhen 518020, Peoples R China

Ju, Chunrong,Lian, Qiaoyan,Wang, Xiaohua,et al. Efficacy of different durations of antifungal prophylaxis with nebulized amphotericin B after lung transplantation: a retrospective cohort study[J]. JOURNAL OF THORACIC DISEASE,2023.

Ju, Chunrong.,Lian, Qiaoyan.,Wang, Xiaohua.,Wang, Lulin.,Zhang, Jianheng.,...&He, Jianxing.(2023).Efficacy of different durations of antifungal prophylaxis with nebulized amphotericin B after lung transplantation: a retrospective cohort study.JOURNAL OF THORACIC DISEASE.

Ju, Chunrong,et al."Efficacy of different durations of antifungal prophylaxis with nebulized amphotericin B after lung transplantation: a retrospective cohort study".JOURNAL OF THORACIC DISEASE (2023).