{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T19:45:05Z","timestamp":1791402305211,"version":"4.3.3"},"reference-count":36,"publisher":"University of Toronto Press Inc. (UTPress)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of the Association of Medical Microbiology and Infectious Disease Canada"],"published-print":{"date-parts":[[2023,3,1]]},"abstract":"<jats:sec><jats:title>Background:<\/jats:title><jats:p>Patients undergoing remission-induction intensive chemotherapy for acute leukemia are at high risk for life-threatening invasive fungal infections (IFIs). Primary antifungal prophylaxis with posaconazole has been shown to reduce the incidence of IFI compared to fluconazole, but real-life data are limited and the effect on mortality remains unclear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods:<\/jats:title><jats:p>This retrospective cohort study compared fluconazole and posaconazole as primary prophylaxis in real-life practice over a 10-year period, in a Canadian hospital.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p>A total of 299 episodes were included (fluconazole, n = 98; posaconazole, n = 201), of which 68% were first inductions. The underlying hematologic malignancy was acute myeloid leukemia or myelodysplastic syndrome in 88% of episodes and acute lymphoblastic leukemia in 9%. Overall, 20 cases of IFI occurred (aspergillosis, n = 17; candidiasis, n = 3) and 14 were considered as breakthrough IFI. IFI incidence was significantly lower in the posaconazole group (3.5% versus 13.2%; p = 0.001). Empirical or targeted antifungal therapy was also reduced in the posaconazole cohort. Mortality was similar in both groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions:<\/jats:title><jats:p>In a real-life setting in Canada, primary posaconazole prophylaxis reduces the incidence of IFI during remission-induction chemotherapy, compared to fluconazole.<\/jats:p><\/jats:sec>","DOI":"10.3138\/jammi-2022-0027","type":"journal-article","created":{"date-parts":[[2023,3,28]],"date-time":"2023-03-28T19:57:37Z","timestamp":1680033457000},"page":"18-28","source":"Crossref","is-referenced-by-count":1,"title":["Real-life comparison of posaconazole versus fluconazole for primary antifungal prophylaxis during remission-induction chemotherapy for acute leukemia"],"prefix":"10.3138","volume":"8","author":[{"given":"Simon F","family":"Dufresne","sequence":"first","affiliation":[{"name":"Centre de Recherche de l\u2019H\u00f4pital Maisonneuve-Rosemont, Montr\u00e9al, Quebec, Canada"},{"name":"Division of Infectious Diseases and Clinical Microbiology, Department of Medicine, 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