Trial reportIntensive care medicine2002
Prevention of severe Candida infections in nonneutropenic, high-risk, critically ill patients: a randomized, double-blind, placebo-controlled trial in patients treated by selective digestive decontamination.
Trial report in Intensive care medicine, 2002. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 83 papers, 13 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
83 citing papers in PubMed, 13 syntheses or guidelines pooled it, 246 citations in OpenAlex.
- [S3 guideline on sepsis-prevention, diagnosis, therapy, and follow-up care-update 2025].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2025Guideline
- Topical antibiotic prophylaxis to reduce respiratory tract infections and mortality in adults receiving mechanical ventilation.The Cochrane database of systematic reviews · 2021Pooled it
- Impact of selective digestive decontamination on respiratory tract Candida among patients with suspected ventilator-associated pneumonia. A meta-analysis.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2016Pooled it
- Clinical Practice Guideline for the Management of Candidiasis: 2016 Update by the Infectious Diseases Society of America.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2016Guideline
- Antifungal agents for preventing fungal infections in non-neutropenic critically ill patients.The Cochrane database of systematic reviews · 2016Pooled it
- Topical antibiotics as a major contextual hazard toward bacteremia within selective digestive decontamination studies: a meta-analysis.BMC infectious diseases · 2014Pooled it
- Risk factors for invasive fungal disease in critically ill adult patients: a systematic review.Critical care (London, England) · 2011Pooled it
- Antibiotic prophylaxis to reduce respiratory tract infections and mortality in adults receiving intensive care.The Cochrane database of systematic reviews · 2009Pooled it
- Clinical practice guidelines for the management of candidiasis: 2009 update by the Infectious Diseases Society of America.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2009Guideline
- Single-drug therapy or selective decontamination of the digestive tract as antifungal prophylaxis in critically ill patients: a systematic review.Critical care (London, England) · 2007Pooled it
- Prophylaxis of Candida infections in adult trauma and surgical intensive care patients: a systematic review and meta-analysis.Intensive care medicine · 2005Pooled it
- Impact of selective decontamination of the digestive tract on fungal carriage and infection: systematic review of randomized controlled trials.Intensive care medicine · 2005Pooled it
- The use of prophylactic fluconazole in immunocompetent high-risk surgical patients: a meta-analysis.Critical care (London, England) · 2005Pooled it
- A randomized, placebo-controlled trial of preemptive antifungal therapy for the prevention of invasive candidiasis following gastrointestinal surgery for intra-abdominal infections.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2015Trial
- Trial
- Oral nystatin prophylaxis of Candida spp. colonization in ventilated critically ill patients.Intensive care medicine · 2005Trial
- Impact of fluconazole prophylaxis on cortisol levels in critically ill surgical patients.Antimicrobial agents and chemotherapy · 2004Trial
- Comment on "Prevention of severe Candida infections in non-neutropenic, high-risk, critically ill patients," by Garbino et al.Intensive care medicine · 2003Trial
- Efficacy and safety of antifungal prophylaxis in surgical intensive care unit patients: A systematic review and meta-analysis of randomized controlled trials.Biomedical reports · 2026Article
- Guidelines for Antibiotics Prescription in Critically Ill Patients.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2024Article
23 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveInfections caused by Candida spp. are a major cause of morbidity and mortality in critically ill patients and usually develop from endogenous colonization. We assessed the effectiveness of adding fluconazole to a selective digestive decontamination regimen to prevent candidal infections. DESIGN AND
settingWe performed a prospective, randomized, double-blind, placebo-controlled trial among medical and surgical intensive care unit patients at a large university hospital. PATIENTS: All adult patients mechanically ventilated for at least 48 h with an expectation to remain so for at least an additional 72 h, and receiving selective decontamination of the digestive tract.
interventionsPatients were randomly assigned fluconazole 100 mg daily (n=103) or placebo (n=101). MEASUREMENTS AND
resultsCandida infections occurred less frequently in the fluconazole group (5.8%) than in the placebo group (16%; rate ratio 0.35; Cl(95) 0.11-0.94). Some 90% of candidemia episodes occurred in the placebo group (rate ratio for fluconazole use 0.10; Cl(95) 0.02-0.74). The rate of treatment failure, development of candidal infection, or increased colonization, was 32% in the fluconazole group and 67% in the placebo group (P<0.001). Crude in-hospital mortality was similar in the two groups (39% fluconazole vs. 41% placebo).
conclusionsProphylactic use of fluconazole in a selected group of mechanically ventilated patients at high risk for infection reduces the incidence of Candida infections, in particular candidemia.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.