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Egger, M; Salmanton-García, J; Barac, A; Gangneux, JP; Guegan, H; Arsic-Arsenijevic, V; Matos, T; Tomazin, R; Klimko, N; Bassetti, M; Hammarström, H; Meijer, EFJ; Meis, JF; Prattes, J; Krause, R; Resat, Sipahi, O; Scharmann, U; White, PL; Desoubeaux, G; García-Rodríguez, J; Garcia-Vidal, C; Martín-Pérez, S; Ruiz, M; Tumbarello, M; Talento, AF; Rogers, B; Lagrou, K; van, Praet, J; Arikan-Akdagli, S; Arendrup, MC; Koehler, P; Cornely, OA; Hoenigl, M, , ECMM, Candida, III, Study, Group$.
Predictors for Prolonged Hospital Stay Solely to Complete Intravenous Antifungal Treatment in Patients with Candidemia: Results from the ECMM Candida III Multinational European Observational Cohort Study.
Mycopathologia. 2023; 188(6):983-994 Doi: 10.1007/s11046-023-00776-4 [OPEN ACCESS]
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Leading authors Med Uni Graz

Egger Matthias Florian

Hönigl Martin

Co-authors Med Uni Graz

Krause Robert

Prattes Jürgen

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Abstract:

BACKGROUND: To date, azoles represent the only viable option for oral treatment of invasive Candida infections, while rates of azole resistance among non-albicans Candida spp. continue to increase. The objective of this sub-analysis of the European multicenter observational cohort study Candida III was to describe demographical and clinical characteristics of the cohort requiring prolonged hospitalization solely to complete intravenous (iv) antifungal treatment (AF Tx). METHODS: Each participating hospital (number of eligible hospitals per country determined by population size) included the first ~ 10 blood culture proven adult candidemia cases occurring consecutively after July 1st, 2018, and treating physicians answered the question on whether hospital stay was prolonged only for completion of intravenous antifungal therapy. Descriptive analyses as well as binary logistic regression was used to assess for predictors of prolonged hospitalization solely to complete iv AF Tx. FINDINGS: Hospital stay was prolonged solely for the completion of iv AF Tx in 16% (100/621) of candidemia cases by a median of 16 days (IQR 8 - 28). In the multivariable model, initial echinocandin treatment was a positive predictor for prolonged hospitalization to complete iv AF Tx (aOR 2.87, 95% CI 1.55 - 5.32, p < 0.001), while (i) neutropenia, (ii) intensive care unit admission, (iii) catheter related candidemia, (iv) total parenteral nutrition, and (v) C. parapsilosis as causative pathogen were found to be negative predictors (aOR 0.22 - 0.45; p < 0.03). INTERPRETATION: Hospital stays were prolonged due to need of iv AF Tx in 16% of patients with candidemia. Those patients were more likely to receive echinocandins as initial treatment and were less severely ill and less likely infected with C. parapsilosis.

Find related publications in this database (using NLM MeSH Indexing)

Adult - administration & dosage

Humans - administration & dosage

Candida - administration & dosage

Antifungal Agents - therapeutic use

Candidemia - microbiology

Length of Stay - administration & dosage

Echinocandins - therapeutic use

Cohort Studies - administration & dosage

Azoles - therapeutic use

Candida parapsilosis - administration & dosage

Risk Factors - administration & dosage

Find related publications in this database (Keywords)

Candida tropicalis

Candida auris

Candida albicans

Candida parapsilosis

Candida glabrata

Mortality

Guidelines

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