Impact of fluconazole administration on outcomes in critically ill patients

The Annals of Pharmacotherapy
James C GarreltsPaul B Harrison

Abstract

Serious infections caused by Candida spp. are an increasingly important cause of morbidity and mortality in critically ill patients. It is unclear which patients will benefit from therapy and at what point to institute treatment. To evaluate the impact of administration of fluconazole therapy in critically ill trauma patients on mortality, length of hospital stay, incidence of deep-seated fungal infection, and positive fungal cultures from any site. We conducted a retrospective, matched case-control study of 116 critically ill surgical trauma patients who did or did not receive fluconazole. Patients were followed until hospital discharge or death. A consecutive sample of 58 patients who received fluconazole was selected. A parallel group of patients was evaluated, from which 58 were matched with fluconazole-treated patients based on age (+/- 5 y), gender, and APACHE II score (+/- 3). The groups of patients were well matched, with the exception of central venous catheter placement and broad-spectrum antibiotic use. We found no difference between groups in hospital mortality (21% vs 26%; p = 0.661) or incidence of deep-seated fungal infection (0% vs 2%; p = NS). However, patients receiving fluconazole had a significantly longer s...Continue Reading

References

Jun 1, 1995·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·W R Jarvis
Jul 1, 1997·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·J E EdwardsM White
Feb 13, 1999·Journal of Clinical Microbiology·Y F BerrouaneM A Pfaller
Apr 19, 2000·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·J H RexJ E Edwards

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Citations

Nov 11, 2005·Critical Care : the Official Journal of the Critical Care Forum·Kwok M HoSteven A R Webb
May 31, 2007·The Annals of Pharmacotherapy·Ryosuke TsurutaTsuyoshi Maekawa
Aug 19, 2006·Critical Care Medicine·Pamela A Lipsett

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Methods Mentioned

BETA
biopsy

Software Mentioned

GraphPad Prism
InStat

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