MONDAY, Oct. 26, 2020 — Preventive antifungal medications cut the risk for death following a lung transplant by more than half, according to a study published online Sept. 23 in the Annals of the American Thoracic Society.

Kelly M. Pennington, M.D., from the Mayo Clinic in Rochester, Minnesota, and colleagues evaluated the effect of antifungal prophylaxis on all-cause mortality and invasive fungal infections (IFI) in lung transplant patients. The analysis included 667 lung transplant recipients (385 received prophylaxis and 282 did not) who were identified through administrative claims data (2005 through 2018).

The researchers found that all-cause mortality was significantly lower in those receiving antifungal prophylaxis versus those not (event rate per 100 person-years: 8.77 versus 18.50; hazard ratio, 0.48; 95 percent confidence interval, 0.26 to 0.71; P = 0.003). There were also lower rates of IFI seen among patients receiving antifungal prophylaxis versus those not receiving prophylaxis (event rate per 100 person-years: 15.09 versus 22.48; hazard ratio, 0.68; 95 percent confidence interval, 0.45 to 1.05; P = 0.08).

“This is the first study to demonstrate a mortality benefit associated with the use of antifungal prophylaxis in lung transplant patients,” Pennington said in a statement. “We still do not know which lung transplant patients receive the most benefit from these medications, and there are other unanswered questions that will require more research.”

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