Prophylactic Fluconazole in Liver Transplant Recipients
Authors: Nina Singh, Victor L. Yu
Journal: Annals of Internal Medicine (2000)

Letters16 May 2000Prophylactic Fluconazole in Liver Transplant RecipientsNina Singh, MD and Victor L. Yu, MDNina Singh, MDVeterans Affairs Medical Center; Pittsburgh, PA 15240 (Singh)Veterans Affairs Medical Center; Pittsburgh, PA 15240 (Yu)Search for more papers by this author and Victor L. Yu, MDVeterans Affairs Medical Center; Pittsburgh, PA 15240 (Singh)Veterans Affairs Medical Center; Pittsburgh, PA 15240 (Yu)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-132-10-200005160-00025 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:In their rigorous study, Winston and colleagues (1) reported that fluconazole use led to a significantly lower incidence of fungal infections after liver transplantation. Although fluconazole was used for nearly 3 months after transplantation, the authors recommended that all liver transplant recipients receive fluconazole for 6 weeks (1). The significant difference in the rate of fungal infections may not have been related to the efficacy of fluconazole but to the definition of fungal infection. A 43% incidence of proven fungal infections in the placebo group is not “relatively high” as stated by the authors but rather the ...References1. Winston DJ, Pakrasi A, Busuttil RW. Prophylactic fluconazole in liver transplant recipients. A randomized, double-blind, placebo-controlled trial. Ann Intern Med. 1999;131:729-37. LinkGoogle Scholar2. Singh N, Gayowski T, Wagener MM, Doyle H, Marino IR. Invasive fungal infections in liver transplant recipients receiving tacrolimus as the primary immunosuppressive agent. Clin Infect Dis. 1997;24:179-84. CrossrefMedlineGoogle Scholar3. Gayowsksi T, Marino IR, Singh N, Doyle H, Wagener MM, Fung JJ, et al . Orthotopic liver transplantation in high risk patients: risk factors associated with mortality and infectious morbidity. Transplantation. 1997;65:499-504. CrossrefGoogle Scholar4. Gleason TG, May AK, Caparelli D, Farr BM, Sawyer MD. Emerging evidence of selection of fluconazole-tolerant fungi in surgical intensive care units. Arch Surg. 1997;132:197-202. CrossrefGoogle Scholar5. Fortun J, Lopez-San Roman A, Velasco JJ, Sanchez-Sousa A, DeVincente E, Nuno J, et al . Susceptibility of Candida glabrata strains with reduced susceptibility of azoles in four liver transplant patients with invasive candidiasis. Eur J Clin Microbiol Infect Dis. 1997;16:314-8. CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Veterans Affairs Medical Center; Pittsburgh, PA 15240 (Singh)Veterans Affairs Medical Center; Pittsburgh, PA 15240 (Yu) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoProphylactic Fluconazole in Liver Transplant Recipients Drew J. Winston , Anita Pakrasi , and Ronald W. Busuttil Metrics Cited ByAntifungal Agents and TherapyFungal infections in liver transplantation: prophylaxis, surveillance, and treatmentResistance to Antifungal Agents 16 May 2000Volume 132, Issue 10Page: 843-844KeywordsFungal pathogensHospitalizationsIntensive care unitsLiver transplantationProphylaxisRenal failureRetransplantationSkin infectionsTransplantationUlcers Issue Published: 16 May 2000 CopyrightCopyright © 2000 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...