Antifungal therapy did not improve outcomes including 30-day all-cause mortality in patients suffering community-acquired perforated peptic ulcer-associated peritonitis with Candida species isolated from their peritoneal fluid

Journal of Microbiology, Immunology, and Infection = Wei Mian Yu Gan Ran Za Zhi
Wei-Sin LiJien-Wei Liu

Abstract

Although patients suffering community-acquired perforated peptic ulcer (PPU)-associated peritonitis with Candida species isolated from their peritoneal fluid have higher chances of mortality and experiencing a complicated postoperative clinical course, universal antifungal therapy for these patients remains controversial. This is a retrospective analysis of the impacts of antifungal therapy on outcomes of patients suffering community-acquired PPU-associated peritonitis with Candida species isolated from their ascites at a medical center in Taiwan. All included patients received source control and antibiotic treatment, with or without additional postoperative antifungal therapy with fluconazole or an echinocandin for at least 3 days. Among the 133 included patients, 76 did not receive (Group 1) and 57 did receive (Group 2) antifungal therapy. Sixteen (12%) of the overall included patients died within 30 days. Shock [odds ratio (OR), 5.6; 95% confidence interval (CI), 1.9-16.5; p = 0.002] and higher Acute Physiology and Chronic Health Evaluation II score (>20; OR, 9.5; 95% CI, 1.1-80.7; p = 0.04) were independently associated with 30-day mortality. Among the 80 matched patients from Groups 1 and 2 (1:1 matched) with the closest p...Continue Reading

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Citations

Jul 24, 2018·Surgical Infections·Christopher B HornGrant V Bochicchio
Jan 11, 2020·World Journal of Emergency Surgery : WJES·Antonio TarasconiFausto Catena
Mar 7, 2020·Current Problems in Surgery·Alice WangTheodore N Pappas
Jun 4, 2021·Trauma Surgery & Acute Care Open·Galinos BarmparasSharmila Dissanaike

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