Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Salmanton-García, J; Reinhold, I; Prattes, J; Bekaan, N; Koehler, P; Cornely, OA.
Questioning the 14-day dogma in candidemia treatment duration.
Mycoses. 2024; 67(1):e13672
Doi: 10.1111/myc.13672
Web of Science
PubMed
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FullText_MUG
- Co-Autor*innen der Med Uni Graz
- Prattes Jürgen
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- Abstract:
- The growing threat of antimicrobial resistance (AMR) is a global concern. With AMR directly causing 1.27 million deaths in 2019 and projections of up to 10 million annual deaths by 2050, optimising infectious disease treatments is imperative. Prudent antimicrobial use, including treatment duration, can mitigate AMR emergence. This is particularly critical in candidemia, a severe condition with a 45% crude mortality rate, as the 14-day minimum treatment period has not been challenged in randomised comparison. A comprehensive literature search was conducted in August 2023, revealing seven original articles and two case series discussing treatment durations of less than 14 days for candidemia. No interventional trials or prospective observational studies assessing shorter durations were found. Historical studies showed varying candidemia treatment durations, questioning the current 14-day minimum recommendation. Recent research observed no significant survival differences between patients receiving shorter or longer treatment, emphasising the need for evidence-based guidance. Treatment duration reduction post-blood culture clearance could decrease exposure to antifungal drugs, limiting selection pressure, especially in the context of emerging multiresistant Candida species. Candidemia's complexity, emerging resistance and potential for shorter in-hospital stays underscore the urgency of refining treatment strategies. Evidence-driven candidemia treatment durations are imperative to balance efficacy with resistance prevention and ensure the longevity of antifungal therapies. Further research and clinical trials are needed to establish evidence-based guidelines for candidemia treatment duration.
- Find related publications in this database (using NLM MeSH Indexing)
- Humans - administration & dosage
- Candidemia - microbiology
- Antifungal Agents - therapeutic use
- Duration of Therapy - administration & dosage
- Microbial Sensitivity Tests - administration & dosage
- Candida - administration & dosage
- Retrospective Studies - administration & dosage
- Risk Factors - administration & dosage
- Observational Studies as Topic - administration & dosage
- Find related publications in this database (Keywords)
- antimicrobial resistance
- Candida
- Candida albicans
- Candida glabrata
- Candida spp.
- Candida tropicalis
- candidemia
- drug resistance
- patient quality of life
- treatment duration