{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T02:34:05Z","timestamp":1789785245535,"version":"4.0.1"},"reference-count":37,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,9,1]],"date-time":"2020-09-01T00:00:00Z","timestamp":1598918400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Antifungal prophylaxis to prevent invasive fungal infections (IFI) is widely used following lung transplantation, but the optimal strategy remains unclear. We compared universal with targeted antifungal prophylaxis for effectiveness in preventing IFI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Adult patients who underwent lung transplantation at the University of Michigan from \/1 July 2014\u201031 December 2017 were studied for 18\u00a0months post\u2010transplant. Universal prophylaxis consisted of itraconazole with or without inhaled liposomal amphotericin B. Using specific criteria, targeted prophylaxis was given with voriconazole for patients at risk for invasive pulmonary aspergillosis (IPA) and with fluconazole or micafungin for patients at risk for invasive candidiasis. Risk factors, occurrence of proven\/probable IFI, and mortality were analyzed for the two prophylaxis cohorts.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 105 lung transplant recipients, 84 (80%) received a double lung transplant, and 38 (36%) of patients underwent transplant for pulmonary fibrosis. Fifty\u2010nine (56%) patients received universal antifungal prophylaxis, and 46 (44%), targeted antifungal prophylaxis. Among 20 proven\/probable IFI, there were 14 IPA, 4 invasive candidiasis, 1 cryptococcosis, and 1 deep sternal mold infection. Six (10%) IFI occurred in the universal prophylaxis cohort and 14 (30%) in the targeted prophylaxis cohort. Five of 6 (83%) IFI in the universal prophylaxis cohort, compared with 9\/14 (64%) in the targeted prophylaxis cohort, were IPA <jats:italic>Candida<\/jats:italic> infections occurred only in the targeted prophylaxis cohort. The development of IFI was more likely in the targeted prophylaxis cohort than the universal prophylaxis cohort, HR\u00a0=\u00a04.32 (1.51\u201012.38), <jats:italic>P<\/jats:italic>\u00a0=\u00a0.0064.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Universal antifungal prophylaxis appears to be more effective than targeted antifungal prophylaxis for prevention of IFI after lung transplant.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tid.13448","type":"journal-article","created":{"date-parts":[[2020,8,15]],"date-time":"2020-08-15T17:06:50Z","timestamp":1597511210000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Evaluation of targeted versus universal prophylaxis for the prevention of invasive fungal infections following lung transplantation"],"prefix":"10.1111","volume":"23","author":[{"given":"Kathleen A.","family":"Linder","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases University of Michigan Health System Ann Arbor MI USA"},{"name":"Veterans Affairs Ann Arbor Healthcare System Ann Arbor MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol A.","family":"Kauffman","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases University of Michigan Health System Ann Arbor MI USA"},{"name":"Veterans Affairs Ann Arbor Healthcare System Ann Arbor MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Twisha S.","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Pharmacy University of Michigan Health System Ann Arbor MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda J.","family":"Fitzgerald","sequence":"additional","affiliation":[{"name":"Department of Pharmacy University of Michigan Health System Ann Arbor MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blair J.","family":"Richards","sequence":"additional","affiliation":[{"name":"Michigan Institute for Clinical and Health Research University of Michigan Ann Arbor MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3175-0512","authenticated-orcid":false,"given":"Marisa H.","family":"Miceli","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases University of Michigan Health System Ann Arbor MI 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