Shorter antifungal prophylaxis is reasonable to prevent oral candidiasis (OC) in patients who undergo kidney and/or pancreas transplantation because of the low incidence of the infection, investigators concluded in a presentation during the virtual 2021 American Transplant Congress.
Lauren Von Stein, PharmD, of The Ohio State Wexner Medical Center in Columbus, and colleagues retrospectively studied 283 patients who received a kidney and/or pancreas. Of these, 87 and 83 received 3 months and 1 month of oral nystatin prophylaxis, respectively, and 68 patients received no prophylaxis.
OC developed in 4 patients (5.9%) in the no-prophylaxis group and none of the patients in either nystatin arm. The median time to OC diagnosis was 27.5 days. OC developed within 30 days post-transplant in 3 of the 4 patients.
“Given the low incidence of OC infections post-transplant and concern for patient adherence, a shortened duration of 1 month of nystatin prophylaxis is reasonable to decrease the occurrence of OC,” the investigators concluded in their study abstract.
The 3 study arms had similar baseline characteristics, with most patients receiving anti-thymocyte globulin induction and tacrolimus with mycophenolate sodium for maintenance immunosuppression.
Von Stein L, Patel S, Wardlow L. Incidence of oral candidiasis in renal and/or pancreas transplant recipients when administering prophylaxis versus no prophylaxis. Presented at: ATC 2021, held June 4-9, 2021. Abstract 801.