ArticleAntimicrobial agents and chemotherapy2008
Association of fluconazole pharmacodynamics with mortality in patients with candidemia.
Article in Antimicrobial agents and chemotherapy, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 47 papers, 1 of them a synthesis that pooled it.
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Who cites it
47 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Antifungal pharmacodynamics: Latin America's perspective.The Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious DiseasesPooled it
- Population Pharmacokinetic Study of Prophylactic Fluconazole in Preterm Infants for Prevention of Invasive Candidiasis.Antimicrobial agents and chemotherapy · 2019Trial
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- Parametric and nonparametric population pharmacokinetic analysis of fluconazole in critically ill patients and dosing simulations forAntimicrobial agents and chemotherapy · 2024Article
- Low-Molecular Pyrazine-Based DNA Binders: Physicochemical and Antimicrobial Properties.Molecules (Basel, Switzerland) · 2022Article
- Antiviral lectin Q-Griffithsin suppresses fungal infection in murine models of vaginal candidiasis.Frontiers in cellular and infection microbiology · 2022Article
- Structural determinants for subnanomolar inhibition of the secreted aspartic protease Sapp1p fromJournal of enzyme inhibition and medicinal chemistry · 2021Article
- The Antibacterial Synthetic Flavonoid BrCl-Flav Exhibits Important Anti-Pharmaceuticals (Basel, Switzerland) · 2021Article
- Antifungal Susceptibility Testing: A Primer for Clinicians.Open forum infectious diseases · 2021Review
- Current fluconazole treatment regimens result in under-dosing of critically ill adults during early therapy.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2021Article
- Analysis of Volatile Molecules Present in the Secretome of the Fungal PathogenMolecules (Basel, Switzerland) · 2021Article
- Model-Informed Drug Development for Anti-Infectives: State of the Art and Future.Clinical pharmacology and therapeutics · 2021Review
- Role and Interpretation of Antifungal Susceptibility Testing for the Management of Invasive Fungal Infections.Journal of fungi (Basel, Switzerland) · 2020Review
- Challenges in Antifungal Therapy in Diabetes Mellitus.Journal of clinical medicine · 2020Article
- Article
- The association between fluconazole dose and MIC with mortality and persistence in candidemia.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2019Article
- AreJournal of clinical microbiology · 2018Review
- Survival in Patients with Candida glabrata Bloodstream Infection Is Associated with Fluconazole Dose.Antimicrobial agents and chemotherapy · 2018Article
- Article
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Abstract
Recent studies of nonneutropenic patients with candidemia or candidiasis suggest that fluconazole pharmacodynamic parameters correlate with clinical outcomes; however, additional data of correlation to mortality in patients with candidemia would be valuable. We assessed the impact of MICs for Candida, fluconazole pharmacodynamics, and patient characteristics on all-cause mortality with use of a prospective cohort of 96 hospitalized patients with candidemia. Among 84 patients for whom Candida isolates were available for testing, the most frequent Candida species isolated were Candida albicans (44%), followed by Candida parapsilosis (20.2%), and Candida glabrata (20.2%). Fluconazole resistance (MIC of >or=64 microg/ml) was present in 7 (8.3%) to 10 (11.9%) of 84 isolates, depending on the MIC endpoint determination method (50% or 80% inhibition read at 24 or 48 h). Overall mortality occurred in 27 (28.1%) of 96 patients, and nonsurvivors were more likely to have fluconazole-resistant isolates (25% versus 6.7%; P = 0.02). Multivariable analysis demonstrated an association between fluconazole resistance and mortality, but it did not reach statistical significance (odds ratio, 5.3; 95% confidence interval, 0.8 to 33.4; P = 0.08). By pharmacodynamic analysis, a fluconazole area under the concentration-time curve/MIC of <11.5 or MIC of >or=64 was associated with increased patient mortality (P <or= 0.09). These data support previous findings of an antifungal exposure-response relationship to mortality in patients with candidemia. In addition, similar MICs were obtained using a 24- or 48-h MIC endpoint determination, thus providing the opportunity to assess earlier the impact of isolate susceptibility on therapy.
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