{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T13:00:00Z","timestamp":1785416400454,"version":"3.56.0"},"reference-count":31,"publisher":"American Society for Microbiology","issue":"6","license":[{"start":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:00:00Z","timestamp":1780444800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T00:00:00Z","timestamp":1780444800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Antimicrob Agents Chemother"],"published-print":{"date-parts":[[2026,6,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      Management of pulmonary mucormycosis includes intravenous liposomal amphotericin-B (L-AmB), followed by posaconazole or isavuconazole. We aimed to determine the optimal L-AmB duration before switching to triazole therapy. Using data from a retrospective study in France, we performed an emulated trial evaluating stopping L-AmB after 14 days (short treatment) versus continuing L-AmB (long treatment). The benefit of combination L-AmB therapy was also investigated. A cloning, censoring, and weighting approach was used to account for immortal time and indication biases. Ninety-four cases of pulmonary mucormycosis were included, of which 35% had dissemination. Eighty-nine patients received L-AmB first-line therapy for a median of 25 (IQR: 12\u201354) days, including 18 patients as combination therapy. L-AmB was discontinued for adverse events in 16\/89 patients (18%). Treatment was switched to posaconazole (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 38) or isavuconazole (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 9) in 47 cases and was switched back to L-AmB due to disease progression in 11\/47 (23%) cases. Overall, the 180-day mortality was 54%. Diagnosis in the ICU, dyspnea at diagnosis, disseminated disease, and ground-glass opacities on chest CT scan were associated with increased mortality. No difference in 180-day survival was found between patients receiving short or long L-AmB treatment (HR=0.80, 95% CI [0.29\u20131.99]) and between patients receiving L-AmB alone or in combination (HR=1.14, 95% CI [0.56\u20132.32]) in emulated trials, although confidence intervals were wide. Switching to triazole therapy after 14 days of L-AmB treatment was as effective as longer durations while reducing L-AmB side effects. Combination therapy did not improve prognosis. These results could inform randomized clinical trials assessing different first-line therapeutic strategies for pulmonary mucormycosis.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1128\/aac.01523-25","type":"journal-article","created":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T14:15:37Z","timestamp":1777472137000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":0,"title":["A step toward defining optimal liposomal amphotericin B treatment duration in pulmonary mucormycosis: results from emulated trials"],"prefix":"10.1128","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9596-662X","authenticated-orcid":false,"given":"Anne","family":"Coste","sequence":"first","affiliation":[{"name":"Infectious Diseases Department, La Cavale Blanche Hospital, Brest University Hospital","place":["Brest, 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On behalf of the medical mycology committee CoSM-Italian association of clinical microbiologists Amcli null, Farina C, p 948. In In vitro activity of Isavuconazole and Amphotericin B in association against mucorales. pathogens. 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