Objective: The present work aimed to review the invasive fungal infections (IFIs) and antifungal prophylaxis used in the last 20 years in transplant patients to identify the changes that occurred in this period and discuss the most current conducts. Methods: This is a systematic review in which the PubMed database was used, in which scientific articles from the last 20 years were selected, covering clinical trials, randomized controlled trials, systematic reviews of the literature and meta-analyses. Results: According to the present study, posaconazole and voriconazole are the antifungal drugs of choice for IFI prophylaxis in hematopoietic stem cell transplantation (HSCT). However, as posaconazole is not available in the public health system in Brazil, the most viable option remains voriconazole. Regarding IFI prophylaxis in solid organ transplantation (SOT), it was observed that there are variations depending on the transplanted target organ, and there is no evidence of its need in kidney transplantation. Although azoles are also the most used and bring clear benefits in liver and lung transplantation, some current studies have placed echinocandins on the same level, encouraging their use to prevent IFI in these patients. Conclusion: In the last five years, there has been a great shortage of clinical trials comparing different antifungal prophylaxis. New studies are needed to establish the most appropriate protocols for each condition and profile of the transplanted patient.

Objetivo: O presente trabalho objetivou revisar as infecções fúngicas invasivas (IFIs) e as profilaxias antifúngicas utilizadas nos últimos 20 anos em pacientes transplantados, de forma a identificar as mudanças ocorridas nesse período e discutir as condutas mais atuais. Métodos: Trata-se de uma revisão sistemática em que se utilizou a base de dados PubMed, na qual foram selecionados artigos científicos dos últimos 20 anos, abrangendo ensaios clínicos, ensaios controlados randomizados, revisões sistemáticas da literatura e metanálises. Resultados: De acordo com o presente estudo, o posaconazol e o voriconazol parecem ser as drogas antifúngicas de escolha na profilaxia de IFI em transplante de células-tronco hematopoiéticas (TCTH). Entretanto, como não há disponibilidade do posaconazol no sistema público de saúde do Brasil, a opção mais viável continua sendo o voriconazol. Com relação à profilaxia de IFI em transplante de órgãos sólidos (TOS), observou-se que existem variações em função do órgão-alvo transplantado, sendo que no transplante renal (TR) nem há evidência da sua necessidade. Apesar dos azóis também serem os mais utilizados e trazerem benefícios evidentes nos transplantes de fígado (TF) e de pulmão (TP), alguns estudos atuais têm colocado as equinocandinas no mesmo patamar, encorajando mais seu uso para prevenção de IFI nesses pacientes. Conclusão: Uma vez que nos últimos 5 anos existe grande escassez de ensaios clínicos comparando diferentes profilaxias antifúngicas, novos estudos são necessários a fim de estabelecerem os protocolos mais adequados para cada condição e perfil de paciente transplantado.

Aims: The fecal microbiota transplantation (FMT) may be a possible solution for symptoms reduction and improvement of the clinical condition in Inflammatory bowel diseases (IBDs), such as Ulcerative Colitis (UC) and Crohn's Disease (CD). In addition to being effective in other conditions associated with disequilibrium in gastrointestinal microbiota, such as recurrent Clostridium difficile infection (RCDI) and Metabolic Syndrome (MS). The aim of this study was to review the applicability of FMT: in UC, CD, RCDI and MS. Study Design: Minireview. Place and Duration of Study: Faculty of Medical Sciences of São José dos Campos- Humanitas, between June 2021 and August 2022. Methodology: A literature search was performed in the PubMed database for clinical trial studies and review articles, published in the last 10 (ten) years. The remission of clinical conditions was established as the primary outcome and exclusion criteria was not blind or incomplete blinding studies. Based on these studies, a review regarding the applications of FMT in patients with IBD, RCDI and MS, especially its therapeutic effects, was performed. Results: In total, 53 (fifty-three) articles were selected. Studies have shown that FMT can be useful in the treatment of RCDI with cure rates ranging from 85% to 90% and represent a possible alternative to antibiotic therapy in cases of primary infection by C. difficile. FMT seems to be effective in inducing remission of UC, but its durability and long-term safety are still not well defined. Furthermore, in the treatment of Crohn's disease and metabolic syndrome, some studies show beneficial effects, but further studies are needed. Conclusion: The studies are optimistic and, even if modest, suggest that FMT has the potential for treatment and/or remission of different inflammatory and infectious conditions.