Abstract Background Fungal periprosthetic joint infection remains a challenging complication in revision arthroplasty. Candida albicans ( C. albicans ) is among the most frequently reported fungal pathogens, and biofilm formation further limits antifungal efficacy. Tranexamic acid (TXA) is routinely used to reduce perioperative blood loss in arthroplasty and may come into direct contact with antifungal agents within the joint environment. However, whether TXA modifies antifungal activity against