Impact of initial empirical antifungal agents on the outcome of critically ill patients with invasive candidiasis: analysis of the China-SCAN study

International Journal of Antimicrobial Agents
Na CuiDawei Liu

Abstract

The effect of different empirical antifungal agents on the clinical outcome of critically ill patients with invasive candidiasis (IC) has not been fully elucidated. In this study, 136 patients with proven IC who received empirical therapy in the China-SCAN multicentre study were retrospectively analysed. Initial empirical antifungal monotherapy consisted of a triazole [fluconazole (n = 61), voriconazole (n = 20) or itraconazole (n = 12)] or an echinocandin (n = 43). Hospital mortality as the primary outcome and global responses (clinical and microbiological) were assessed. The results indicated that rates of hospital mortality (P = 0.006) and intensive care unit (ICU) mortality (P = 0.011) were significantly lower in patients treated with an echinocandin compared with those receiving fluconazole, voriconazole or itraconazole. Multivariate regression analysis indicated that the type of antifungal agent used in empirical therapy was an independent predictor of hospital mortality (P = 0.033). Initial empirical echinocandin treatment was associated with decreased hospital mortality compared with fluconazole [odds ratio (OR) = 0.22, 95% confidence interval (CI) 0.06-0.85; P = 0.028], voriconazole (OR = 0.11, 95% CI 0.02-0.56; P = 0....Continue Reading

References

Jun 5, 2004·Clinical Pharmacology and Therapeutics·Yasuhiko IkedaMitsuyoshi Nakashima
Jan 27, 2016·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Peter G PappasJack D Sobel

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Citations

Apr 10, 2018·Journal of Intensive Care Medicine·Hasan M Al-DorziYaseen M Arabi
Jul 13, 2021·Infectious Diseases·Fleischer Cn KoteyEric S Donkor

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