Table 5.

Suggested prophylactic regimens for endemic fungi in SOT recipients

	Recipient Peritransplant Prophylaxis	Secondary Prophylaxis for Recipients After Completion of Treatment Course
Histoplasmosis	Donor with localized pulmonary disease: itraconazole 200 mg once or twice daily for 3–6 mo Donor with disseminated disease: itraconazole 200 mg once or twice daily for 12 mo84	Not routinely indicated. Can monitor urine antigen level every 3 mo to determine need. If required, consider itraconazole 200 mg/d.16,84
Blastomycosis	Donor with localized pulmonary disease: itraconazole 200 mg once or twice daily for 3–6 mo Donor with disseminated disease: itraconazole 200 mg once or twice daily for 12 mo	Not routinely indicated. If required, consider itraconazole 200 mg/d.17
Coccidioidomycosis	Donor with isolated pulmonary disease: fluconazole 400 mg/d for 3–12 mo (non-lung recipients) or lifelong (lung recipients). Donor with positive serology or extrapulmonary disease: fluconazole 400 mg/d lifelong.84 Recipient with positive serology or history of coccidioidomycosis: fluconazole 200 mg/d for 6–12 mo. Recipient living in a Coccidioides-endemic area: fluconazole 200 mg/d for 6–12 mo.59	Fluconazole 400 mg/d indefinitely.59

Abbreviation: SOT, solid organ transplantation.