ArticleAntimicrobial agents and chemotherapy2012
Impact of prior inappropriate fluconazole dosing on isolation of fluconazole-nonsusceptible Candida species in hospitalized patients with candidemia.
Article in Antimicrobial agents and chemotherapy, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers.
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Who cites it
33 citing papers in PubMed, 61 citations in OpenAlex.
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- Tracking Candidemia Trends and Antifungal Resistance Patterns across Europe: An In-Depth Analysis of Surveillance Systems and Surveillance Studies.Journal of fungi (Basel, Switzerland) · 2024Article
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- Prescribing patterns of echinocandins in adult patients in a private hospital in Gauteng, South Africa.Southern African journal of infectious diseases · 2023Article
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- Clinical and mycological investigations of post-COVID-19 acute invasive fungal sinusitis.Laryngoscope investigative otolaryngology · 2022Article
- Creation and Internal Validation of a Clinical Predictive Model for Fluconazole Resistance in Patients WithOpen forum infectious diseases · 2022Article
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- Surveillance of Antifungal Resistance in Candidemia Fails to Inform Antifungal Stewardship in European Countries.Journal of fungi (Basel, Switzerland) · 2022Article
- Article
- Characteristics of antifungal utilization for hospitalized children in the United States.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2022Article
- Antifungal resistance in patients with Candidaemia: a retrospective cohort study.BMC infectious diseases · 2020Article
- Species Distribution and Antifungal Susceptibility of Invasive Candidiasis: A 2016-2017 Multicenter Surveillance Study in Beijing, China.Infection and drug resistance · 2020Article
- Clonal Spread of Candida glabrata Bloodstream Isolates and Fluconazole Resistance Affected by Prolonged Exposure: a 12-Year Single-Center Study in Belgium.Antimicrobial agents and chemotherapy · 2018Article
- Overtreatment of Asymptomatic Candiduria among Hospitalized Patients: a Multi-institutional Study.Antimicrobial agents and chemotherapy · 2018Article
- Antifungal stewardship considerations for adults and pediatrics.Virulence · 2017Review
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Prior use of fluconazole is a modifiable risk factor for the isolation of fluconazole-nonsusceptible Candida species. Optimization of the use of fluconazole by appropriate dose or duration may be able to minimize the risk of resistance. The objective of this study was to evaluate the effects of prior fluconazole therapy, including the dose and duration, on fluconazole susceptibility among Candida species isolated from hospitalized patients with candidemia. A retrospective cohort study of hospitalized patients with a first occurrence of nosocomial candidemia, from 2006 to 2009, was carried out. The relationships between the initial dose and duration of prior fluconazole therapy and the isolation of fluconazole-nonsusceptible Candida species were assessed. An initial fluconazole dose greater than 2 mg/kg and less than 6 mg/kg of body weight was considered suboptimal. A total of 177 patients were identified, of whom 133 patients aged 61 ± 16 years (56% male, 51% Caucasian, 51% with an APACHE II score of ≥ 15) had candidemia more than 2 days after the hospital admission day. Nine of 107 (8%) patients with fluconazole-susceptible Candida species and 9 of 26 (35%) patients with fluconazole-nonsusceptible Candida species had prior fluconazole exposure (risk ratio [RR], 3.03; 95% confidence interval [95% CI], 1.57 to 5.86; P, 0.0022). Preexposure with an initial dose of fluconazole greater than 2 mg/kg and less than 6 mg/kg occurred in 3 of 9 (33%) and 8 of 9 (89%) patients with fluconazole-susceptible and fluconazole-nonsusceptible Candida species, respectively (P, 0.0498). We conclude that patients with candidemia due to fluconazole-nonsusceptible Candida species were more likely to have received prior fluconazole therapy. Suboptimal initial dosing of prior fluconazole therapy was associated with candidemia with fluconazole-nonsusceptible Candida species.
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