SynthesisCritical care (London, England)2005
The use of prophylactic fluconazole in immunocompetent high-risk surgical patients: a meta-analysis.
Synthesis in Critical care (London, England), 2005. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.
What it found
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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.
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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
15 citing papers in PubMed, 2 syntheses or guidelines pooled it, 43 citations in OpenAlex.
- Antifungal agents for preventing fungal infections in non-neutropenic critically ill patients.The Cochrane database of systematic reviews · 2016Pooled it
- Risk factors for invasive fungal disease in critically ill adult patients: a systematic review.Critical care (London, England) · 2011Pooled it
- Trial
- Fluconazole tolerance and virulence adaptations ofJournal of oral microbiology · 2025Article
- Prophylaxis of Invasive Fungal Infection in Neonates: A Narrative Review for Practical Purposes.Journal of fungi (Basel, Switzerland) · 2023Article
- Video-assisted thoracoscopic surgery for invasive pulmonary fungal infection in haematology patients.Journal of thoracic disease · 2019Article
- Candida Species Biofilms' Antifungal Resistance.Journal of fungi (Basel, Switzerland) · 2017Review
- Possible association between fluconazole administration and acute hyperkalemia in a critically ill cyanotic infant.Archives of medical science : AMS · 2015Article
- Risk prediction for invasive candidiasis.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2014Review
- Treatment and prophylaxis of invasive candidiasis.Seminars in perinatology · 2012Review
- Economic considerations of antifungal prophylaxis in patients undergoing surgical procedures.Therapeutics and clinical risk management · 2011Article
- Article
- Caspofungin for prevention of intra-abdominal candidiasis in high-risk surgical patients.Intensive care medicine · 2009Article
- Epidemiology of invasive candidiasis: a persistent public health problem.Clinical microbiology reviews · 2007Review
- Use of prophylactic fluconazole in a neonatal intensive care unit: efficacy is similar to that described in adult high-risk surgical patients.Critical care (London, England) · 2006Article
Corrections and comments
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Authors and funding
4 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionHigh-risk surgical patients are at increased risk of fungal infections and candidaemia. Evidence from observational and small randomised controlled studies suggests that prophylactic fluconazole may be effective in reducing fungal infection and mortality. We evaluated the effects of prophylactic fluconazole on the incidence of candidaemia and hospital mortality in immunocompetent high-risk surgical patients.
methodsRandomised controlled studies involving the use of fluconazole in immunocompetent high-risk surgical patients from the Cochrane Controlled Trial Register (2005, issue 1) and from the EMBASE and MEDLINE databases (1966-30 April 2005), without any language restriction, were included. Two reviewers reviewed the quality of the studies and performed data extraction independently.
resultsSeven randomised controlled studies with a total of 814 immunocompetent high-risk surgical patients were considered. The use of prophylactic fluconazole was associated with a reduction in the proportion of patients with candidaemia (relative risk [RR] = 0.21, 95% confidence interval [CI] = 0.06-0.72, P = 0.01; I2 = 0%) and fungal infections other than lower urinary tract infection (RR = 0.39, 95% CI = 0.24-0.65, P = 0.0003; I2 = 0%), but was associated with only a trend towards a reduction in hospital mortality (RR = 0.82, 95% CI = 0.62-1.08, P = 0.15; I2 = 7%). The proportion of patients requiring systemic amphotericin B as a rescue therapy for systemic fungal infection was lower after prophylactic use of fluconazole (RR = 0.35, 95% CI = 0.17-0.72, P = 0.004; I2 = 0%). The proportion of patients colonised with or infected with fluconazole-resistant fungi was not significantly different between the fluconazole group and the placebo group (RR = 0.66, 95% CI = 0.22-1.96, P = 0.46; I2 = 0%).
conclusionThe use of prophylactic fluconazole in immunocompetent high-risk surgical patients is associated with a reduced incidence of candidaemia but with only a trend towards a reduction in hospital mortality.
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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.