SynthesisIntensive care medicine2005
Prophylaxis of Candida infections in adult trauma and surgical intensive care patients: a systematic review and meta-analysis.
Synthesis in Intensive care medicine, 2005. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 6 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
45 citing papers in PubMed, 6 syntheses or guidelines pooled it, 123 citations in OpenAlex.
- 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
- A research agenda on the management of intra-abdominal candidiasis: results from a consensus of multinational experts.Intensive care medicine · 2013Guideline
- Risk factors for invasive fungal disease in critically ill adult patients: a systematic review.Critical care (London, England) · 2011Pooled it
- Inflammation and the host response to injury, a large-scale collaborative project: patient-oriented research core--standard operating procedures for clinical care VII--Guidelines for antibiotic administration in severely injured patients.The Journal of trauma · 2008Guideline
- 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
- Trial
- 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
- ISCCM Position Statement on the Management of Invasive Fungal Infections in the Intensive Care Unit.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2024Article
- ESICM/ESCMID task force on practical management of invasive candidiasis in critically ill patients.Intensive care medicine · 2019Article
- Guidelines for Antibiotic Prescription in Intensive Care Unit.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2019Article
- Choosing Optimal Antifungal Agents To Prevent Fungal Infections in Nonneutropenic Critically Ill Patients: Trial Sequential Analysis, Network Meta-analysis, and Pharmacoeconomic Analysis.Antimicrobial agents and chemotherapy · 2017Article
- Strategies to Reduce Mortality in Adult and Neonatal Candidemia in Developing Countries.Journal of fungi (Basel, Switzerland) · 2017Review
- Article
- Emerging pan-resistance in Trichosporon species: a case report.BMC infectious diseases · 2016Article
- Antimicrobials: a global alliance for optimizing their rational use in intra-abdominal infections (AGORA).World journal of emergency surgery : WJES · 2016Review
- Candida colonization as a risk marker for invasive candidiasis in mixed medical-surgical intensive care units: development and evaluation of a simple, standard protocol.Journal of clinical microbiology · 2015Article
- Empiric/pre-emptive anti-Candida therapy in non-neutropenic ICU patients.F1000prime reports · 2015Review
- Resistance patterns and clinical significance of Candida colonization and infection in combat-related injured patients from iraq and afghanistan.Open forum infectious diseases · 2014Article
- Risk prediction for invasive candidiasis.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2014Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo determine whether systemic antifungal prophylaxis decreases infectious morbidity and mortality in nonneutropenic, critically ill, trauma and surgical intensive care unit (ICU) adult patients.
designSystematic review and meta-analysis of randomized clinical trials. We used a fixed effect model, with risk ratio (RR) and 95% confidence intervals (CI).
participantsPatients admitted to ICU after surgery or trauma, with multiple risk factors for fungal infections.
interventionsNine studies (seven double blind) with a total of 1,226 patients compared ketoconazole (three) or fluconazole (six) to placebo (eight) or no treatment (one).
resultsProphylaxis with azole was associated with reduced rates of candidemia (RR 0.30, 95% CI 0.10-0.82), mortality attributable to Candida infection (RR 0.25, 95% CI 0.08-0.80), and overall mortality (RR 0.60, 95% CI 0.45-0.81). Time to event analysis showed a significantly lower probability of fungal infections in treated patients. There was no evidence of statistical heterogeneity between studies, and publication bias assessment gave a negative results. There was, however, wide variability in the definition and reporting of some relevant clinical outcomes (e.g., confirmed or suspected infections, colonization) and pooling of these outcome measures was not feasible.
conclusionsProphylaxis of candidal infection among critically ill ICU patients has beneficial effect on certain outcome measures, but additional data from well designed clinical trials and long-term epidemiological observations are needed to provide firm recommendations for the selection of subgroups of patients who would most benefit from prophylaxis and to determine the effect of prophylaxis on fungal resistance patterns.
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What OpenQuestion holds
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.