ArticleAntimicrobial agents and chemotherapy2010
Effect of antifungal therapy timing on mortality in cancer patients with candidemia.
Article in Antimicrobial agents and chemotherapy, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 44 papers, 1 of them a synthesis that pooled it.
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Who cites it
44 citing papers in PubMed, 1 synthesis or guideline pooled it, 128 citations in OpenAlex.
- Central venous catheter (CVC) removal for patients of all ages with candidaemia.The Cochrane database of systematic reviews · 2016Pooled it
- Epidemiology, Risk Factors and Clinical Outcome of Candidaemia:Sultan Qaboos University medical journal · 2025Observational
- Epidemiology and Clinical Features ofJournal of fungi (Basel, Switzerland) · 2025Article
- Diagnostic and prognostic value of time to positivity in blood cultures. An opinion paper.Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2025Review
- Time-to-Positivity for Candida in Bloodstream Infections: Prognostic Implications for Mortality.Cureus · 2024Article
- Fungal infections in immunocompromised critically ill patients.Journal of intensive medicine · 2024Review
- Amphotericin B in the Era of New Antifungals: Where Will It Stand?Journal of fungi (Basel, Switzerland) · 2024Review
- Article
- Evaluation of an Antifungal Stewardship Initiative Targeting Micafungin at an Academic Medical Center.Antibiotics (Basel, Switzerland) · 2023Article
- Clinical and Microbiological Characteristics of Candidemia Cases in Saudi Arabia.Infection and drug resistance · 2023Article
- Analyzing Adherence to the 2016 Infectious Diseases Society of America Guidelines for Candidemia in Cancer Patients.Open forum infectious diseases · 2022Article
- A novel rRNA hybridization-based approach to rapid, accurate Candida identification directly from blood culture.Medical mycology · 2022Article
- Diagnosis and Treatment of Invasive Candidiasis.Antibiotics (Basel, Switzerland) · 2022Review
- Mortality-associated factors of candidemia: a multi-center prospective cohort in Turkey.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2022Observational
- Characterizing Safety and Clinical Outcomes Associated with High-Dose Micafungin Utilization in Patients with Proven Invasive Candidiasis.Tropical medicine and infectious disease · 2022Article
- Appropriate empirical antifungal therapy is associated with a reduced mortality rate in intensive care unit patients with invasive fungal infection: A real-world retrospective study based on the MIMIC-IV database.Frontiers in medicine · 2022Article
- Direct Fluconazole Disk Susceptibility Testing for Candida glabrata-Positive Blood Cultures.Journal of clinical microbiology · 2021Article
- Epidemiology, species distribution, and outcome of nosocomial Candida spp. bloodstream infection in Shanghai: an 11-year retrospective analysis in a tertiary care hospital.Annals of clinical microbiology and antimicrobials · 2021Article
- Article
- Candidemia in Adults at a Tertiary Hospital in China: Clinical Characteristics, Species Distribution, Resistance, and Outcomes.Mycopathologia · 2018Article
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Prior studies have shown that delays in treatment are associated with increased mortality in patients with candidemia. The purpose of this study was to measure three separate time periods comprising the diagnosis and treatment of candidemia and to determine which one(s) is associated with hospital mortality. Patients with blood cultures positive for Candida spp. were identified. Subjects were excluded if no antifungal therapy was given or if there was preexisting antifungal therapy. Collected data included the time from blood culture collection to positivity (incubation period), the time from blood culture positivity to provider notification (provider notification period), and the time from provider notification to the first dose of antifungal given (antifungal initiation period). These times were assessed as predictors of inpatient mortality. A repeat analysis was done with adjustments for age, sex, race, underlying cancer, catheter removal, APACHE III score, acute renal failure, neutropenia, and non-Candida albicans species. A total of 106 episodes of candidemia were analyzed. The median incubation time was 32.1 h and was associated with mortality (univariate hazard ratio per hour, 1.025; P = 0.001). The median provider notification and antifungal initiation periods were 0.3 and 7.5 h, respectively, and were not associated with mortality. Adjusted analysis yielded similar results. For cancer patients with candidemia, the incubation period accounts for a significant amount of time, compared with the provider notification and antifungal initiation times, and is associated with in-hospital mortality. Strategies to shorten the incubation time, such as utilizing rapid molecularly based diagnostic methods, may help reduce in-hospital mortality.
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