Trial reportPloS one2012
β-D-glucan surveillance with preemptive anidulafungin for invasive candidiasis in intensive care unit patients: a randomized pilot study.
Trial report in PloS one, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00672841 (Randomized Comparison of β-D-Glucan Surveillance With Preemptive Anidulafungin Versus Standard Care for the Management of Invasive Candidiasis in Surgical Intensive Care Unit Patients), which is not on this map. Cited by 48 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.
Randomized Comparison of β-D-Glucan Surveillance With Preemptive Anidulafungin Versus Standard Care for the Management of Invasive Candidiasis in Surgical Intensive Care Unit Patients
Who cites it
48 citing papers in PubMed, 6 syntheses or guidelines pooled it.
- (1→3)-β-D-glucan testing for the detection of invasive fungal infections in immunocompromised or critically ill people.The Cochrane database of systematic reviews · 2020Pooled it
- Microbiological Laboratory Testing in the Diagnosis of Fungal Infections in Pulmonary and Critical Care Practice. An Official American Thoracic Society Clinical Practice Guideline.American journal of respiratory and critical care medicine · 2019Guideline
- Intensive care medicine research agenda on invasive fungal infection in critically ill patients.Intensive care medicine · 2017Pooled it
- 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
- Brazilian guidelines for the diagnosis and treatment of candidemia and invasive candidiasis in adults and children.The Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious DiseasesGuideline
- (1 → 3)-β-D-Glucan-guided antifungal therapy in adults with sepsis: the CandiSep randomized clinical trial.Intensive care medicine · 2022Trial
- (1,3)-β-D-Glucan-based empirical antifungal interruption in suspected invasive candidiasis: a randomized trial.Critical care (London, England) · 2020Trial
- Biomarker-based strategy for early discontinuation of empirical antifungal treatment in critically ill patients: a randomized controlled trial.Intensive care medicine · 2017Trial
- A randomized, placebo-controlled trial of preemptive antifungal therapy for the prevention of invasive candidiasis following gastrointestinal surgery for intra-abdominal infections.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2015Trial
- Decision-Rule Architecture in Fungal Biomarker-Guided Antifungal Stewardship for Critically Ill Adults: A Systematic Review andJournal of fungi (Basel, Switzerland) · 2026Review
- Fungal β-1,3-glucans: Cell Wall Constituents That Promote Gut Health Through Innate Immune Modulation.Nutrients · 2026Review
- Efficacy and safety of antifungal prophylaxis in surgical intensive care unit patients: A systematic review and meta-analysis of randomized controlled trials.Biomedical reports · 2026Article
- Fungal diagnostic stewardship in immunocompromised populations: a focus on molds and dimorphic fungi.Clinical microbiology reviews · 2026Review
- Antifungal treatment strategies and their impact on resistance development in clinical settings.The Journal of antimicrobial chemotherapy · 2025Review
- 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
- Evaluation of an Antifungal Stewardship Initiative Targeting Micafungin at an Academic Medical Center.Antibiotics (Basel, Switzerland) · 2023Article
- The influence of continuous renal replacement therapy on 1,3-β-d-glucan levels in critically ill patients: a single-center retrospective propensity score study.Renal failure · 2023Article
- Multicenter Prospective Study of Biomarkers for Diagnosis of Invasive Candidiasis in Children and Adolescents.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022Observational
- Continuing Shifts in Epidemiology and Antifungal Susceptibility Highlight the Need for Improved Disease Management of Invasive Candidiasis.Microorganisms · 2022Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
Abstract
backgroundInvasive candidiasis (IC) is a devastating disease. While prompt antifungal therapy improves outcomes, empiric treatment based on the presence of fever has little clinical impact. Β-D-Glucan (BDG) is a fungal cell wall component detectable in the serum of patients with early invasive fungal infection (IFI). We evaluated the utility of BDG surveillance as a guide for preemptive antifungal therapy in at-risk intensive care unit (ICU) patients.
methodsPatients admitted to the ICU for ≥ 3 days and expected to require at least 2 additional days of intensive care were enrolled. Subjects were randomized in 3:1 fashion to receive twice weekly BDG surveillance with preemptive anidulafungin in response to a positive test or empiric antifungal treatment based on physician preference.
resultsSixty-four subjects were enrolled, with 1 proven and 5 probable cases of IC identified over a 2.5 year period. BDG levels were higher in subjects with proven/probable IC as compared to those without an IFI (117 pg/ml vs. 28 pg/ml; p<0.001). Optimal assay performance required 2 sequential BDG determinations of ≥ 80 pg/ml to define a positive test (sensitivity 100%, specificity 75%, positive predictive value 30%, negative predictive value 100%). In all, 21 preemptive and 5 empiric subjects received systemic antifungal therapy. Receipt of preemptive antifungal treatment had a significant effect on BDG concentrations (p< 0.001). Preemptive anidulafungin was safe and generally well tolerated with excellent outcome.
conclusionsBDG monitoring may be useful for identifying ICU patients at highest risk to develop an IFI as well as for monitoring treatment response. Preemptive strategies based on fungal biomarkers warrant further study.
trial registrationClinical Trials.gov NCT00672841.
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