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Background and Importance Paediatric patients undergoing allogeneic haematopoietic stem cell transplantation (HSCT) require primary antifungal prophylaxis (PAP) until day +100 post-HSCT or until immune reconstitution is achieved. According to protocol, intravenous (IV) micafungin is administered during hospitalisation (until engraftment and oral tolerance is established). After discharge, different strategies may be employed: azole derivatives as first-line, IV amphotericin B twice weekly, or IV micafungin twice weekly.Aim and Objectives To evaluate safety and efficacy of different PAP in HSCT paediatric patients after discharge.Material and Methods Paediatric patients HSCT recipients between January 2022 and July 2025 were retrospectively studied by its demographics, their PAP, the prevalence of IFD and the associated side effects.Results A sample of 30 patients was studied with an average age at HSCT of 8,7 years old (0,83-16,7) and 43,33% female; after the hospitalisation period, 93,33% (n=28) received oral posaconazole, 3,33% (n=1) IV amphotericin B twice weekly and 3,33% (n=1) oral voriconazole. All of them received the indicated dose for their weight.Concerning patient safety, 50% (n=15) suffered side effects; Fourteen were patients treated prophylactically with oral posaconazole which developed hepatotoxicity and 10 of them required PAP switch. One of them developed nephrotoxicity due to voriconazole use and didn’t require a treatment change.In those patients who switched PAP due to toxicity (n=10) amphotericin B twice weekly or micafungine twice weekly were used depending on clinical status, desired spectrum or interactions risks. Five patients changed to micafungin and five to amphotericin B. From this last group of patients, two of them required a second switch due to nephrotoxicity: one patient restarted oral posaconazole and one patient changed to micafungin.From those patients who switched PAP to IV micafungin 3-4 mg/kg twice weekly (n=6), none of them suffered side effects.Concerning prophylaxis efficacy, 10% (n=3) of the whole sample suffered an IFD while on PAP. Two of these patients were receiving IV micafungin as PAP and the other one was receiving oral posaconazole.Conclusion and Relevance All PAP studied were effective. However, there’s a high prevalence of side effects. Micafungin 3-4 mg/kg twice weekly is safe and could be the first option for patients sensitive to suffer side effects.Conflict of Interest No conflict of interest