{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T01:11:45Z","timestamp":1768871505340,"version":"3.49.0"},"reference-count":39,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2021,12,29]],"date-time":"2021-12-29T00:00:00Z","timestamp":1640736000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004319","name":"Pfizer","doi-asserted-by":"publisher","award":["59276319 \u2010 WP2485056"],"award-info":[{"award-number":["59276319 \u2010 WP2485056"]}],"id":[{"id":"10.13039\/100004319","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Mycoses"],"published-print":{"date-parts":[[2022,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Antifungal treatment duration and changes for invasive mould infections (IMI) have been poorly described.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a 10\u2010year cohort study of adult (\u226518\u2010year\u2010old) allogeneic haematopoietic cell transplant recipients with proven\/probable IMI to describe the duration and changes of antifungal treatment. All\u2010cause\u201012\u2010week mortality was described.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sixty\u2010one patients with 66 IMI were identified. Overall treatment duration was 157\u00a0days (IQR: 14\u2013675) and 213 (IQR: 90\u2013675) days for patients still alive by Day 84 post\u2010IMI diagnosis. There was at least one treatment change in 57\/66 (86.4%) cases: median 2, (IQR: 0\u20136, range:0\u20138). There were 179 antifungal treatment changes due to 193 reasons: clinical efficacy (104\/193, 53.9%), toxicity (55\/193, 28.5%), toxicity or drug interactions resolution (15\/193, 7.8%) and logistical reasons (11\/193, 5.7%) and 15\/193 (7.8%) changes due to unknown reasons. Clinical efficacy reasons included lack of improvement (34\/104, 32.7%), targeted treatment (30\/104, 28.8%), subtherapeutic drug levels (14\/104, 13.5%) and other (26\/104, 25%). Toxicity reasons included hepatotoxicity, nephrotoxicity, drug interactions, neurotoxicity and other in 24 (43.6%), 12 (21.8%), 12 (21.8%), 4 (7.4%) and 3 (5.5%) cases respectively. All\u2010cause 12\u2010week mortality was 31% (19\/61), higher in patients whose antifungal treatment (logrank 0.04) or appropriate antifungal treatment (logrank 0.01) was started &gt;7\u00a0days post\u2010IMI diagnosis. All\u2010cause 1\u2010year mortality was higher in patients with \u22652 changes of treatment during the first 6\u00a0weeks post\u2010IMI diagnosis (logrank 0.008) with an OR: 4.00 (<jats:italic>p<\/jats:italic>\u00a0=\u00a0.04).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients with IMI require long treatment courses with multiple changes for variable reasons and potential effects on clinical outcomes, demonstrating the need more effective and safer treatment options. Early initiation of appropriate antifungal treatment is associated with improved outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/myc.13416","type":"journal-article","created":{"date-parts":[[2021,12,22]],"date-time":"2021-12-22T14:36:04Z","timestamp":1640183764000},"page":"199-210","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Frequency and causes of antifungal treatment changes in allogeneic haematopo\u00efetic cell transplant recipients with invasive mould infections"],"prefix":"10.1111","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0394-9636","authenticated-orcid":false,"given":"Romain Samuel","family":"Roth","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases University Hospital of Geneva Geneva 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