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This position paper establishes broadly applicable definitions of breakthrough\n                    <jats:styled-content style=\"fixed-case\">IFI<\/jats:styled-content>\n                    for clinical research. Representatives of the Mycoses Study Group Education and Research Consortium (\n                    <jats:styled-content style=\"fixed-case\">MSG<\/jats:styled-content>\n                    \u2010\n                    <jats:styled-content style=\"fixed-case\">ERC<\/jats:styled-content>\n                    ) and the European Confederation of Medical Mycology (\n                    <jats:styled-content style=\"fixed-case\">ECMM<\/jats:styled-content>\n                    ) reviewed the relevant English literature for definitions applied and published through 2018. A draft proposal for definitions was developed and circulated to all members of the two organisations for comment and suggestions. The authors addressed comments received and circulated the updated document for approval. Breakthrough\n                    <jats:styled-content style=\"fixed-case\">IFI<\/jats:styled-content>\n                    was defined as any\n                    <jats:styled-content style=\"fixed-case\">IFI<\/jats:styled-content>\n                    occurring during exposure to an antifungal drug, including fungi outside the spectrum of activity of an antifungal. The time of breakthrough\n                    <jats:styled-content style=\"fixed-case\">IFI<\/jats:styled-content>\n                    was defined as the first attributable clinical sign or symptom, mycological finding or radiological feature. The period defining breakthrough\n                    <jats:styled-content style=\"fixed-case\">IFI<\/jats:styled-content>\n                    depends on pharmacokinetic properties and extends at least until one dosing interval after drug discontinuation. Persistent\n                    <jats:styled-content style=\"fixed-case\">IFI<\/jats:styled-content>\n                    describes\n                    <jats:styled-content style=\"fixed-case\">IFI<\/jats:styled-content>\n                    that is unchanged\/stable since treatment initiation with ongoing need for antifungal therapy. It is distinct from refractory\n                    <jats:styled-content style=\"fixed-case\">IFI<\/jats:styled-content>\n                    , defined as progression of disease and therefore similar to non\u2010response to treatment. Relapsed\n                    <jats:styled-content style=\"fixed-case\">IFI<\/jats:styled-content>\n                    occurs after treatment and is caused by the same pathogen at the same site, although dissemination can occur. These proposed definitions are intended to support the design of future clinical trials and epidemiological research in clinical mycology, with the ultimate goal of increasing the comparability of clinical trial results.\n                  <\/jats:p>","DOI":"10.1111\/myc.12960","type":"journal-article","created":{"date-parts":[[2019,6,29]],"date-time":"2019-06-29T09:24:52Z","timestamp":1561800292000},"page":"716-729","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":208,"title":["Defining breakthrough invasive fungal infection\u2013Position paper of the mycoses study group education and research consortium and the European Confederation of Medical Mycology"],"prefix":"10.1111","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9599-3137","authenticated-orcid":false,"given":"Oliver A.","family":"Cornely","sequence":"first","affiliation":[{"name":"Cologne Excellence Cluster on Cellular Stress Responses in Aging\u2010Associated Diseases (CECAD) University of Cologne Cologne Germany"},{"name":"Department I of Internal Medicine ECMM Center of Excellence for Medical Mycology German Centre for Infection Research, Partner Site Bonn\u2010Cologne (DZIF) University of Cologne Cologne Germany"},{"name":"Clinical Trials Centre Cologne (ZKS K\u00f6ln) University of Cologne Cologne Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1653-2824","authenticated-orcid":false,"given":"Martin","family":"Hoenigl","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases University of California San Diego San Diego CA USA"},{"name":"Division of Pulmonology and Section of Infectious Diseases Medical University of Graz Graz Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cornelia","family":"Lass\u2010Fl\u00f6rl","sequence":"additional","affiliation":[{"name":"Division of Hygiene and Microbiology ECMM Excellence Center for Medical Mycology Medical University Innsbruck Innsbruck Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon C. \u2010A.","family":"Chen","sequence":"additional","affiliation":[{"name":"Centre for Infectious Diseases and Microbiology Laboratory Services ICPMR New South Wales Health Pathology Westmead Hospital Centre for Infectious Diseases and Microbiology Sydney Medical School The University of Sydney Sydney NSW Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8051-2940","authenticated-orcid":false,"given":"Dimitrios P.","family":"Kontoyiannis","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Infection Control, and Employee Health University of Texas M. 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