ArticleJournal of intensive care2015
Antifungal therapy in patients with pulmonary Candida spp. colonization may have no beneficial effects.
Article in Journal of intensive care, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 2 of them syntheses that pooled it.
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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.
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Who cites it
14 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Pooled it
- The "Choosing Wisely" initiative in infectious diseases.Infection · 2017Pooled it
- Structural Equation Modelling as a Proof-of-Concept Tool for Mediation Mechanisms Between Topical Antibiotic Prophylaxis and Six Types of Blood Stream Infection Among ICU Patients.Antibiotics (Basel, Switzerland) · 2024Review
- Staphylococcus aureus hitchhiking from colonization to bacteremia via Candida within ICU infection prevention studies: a proof of concept modelling.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2023Observational
- Treatments and Outcomes of Critically Ill Patients withThe Canadian journal of hospital pharmacy · 2023Article
- Candida and the Gram-positive trio: testing the vibe in the ICU patient microbiome using structural equation modelling of literature derived data.Emerging themes in epidemiology · 2022Article
- Clinical Implication ofInfection & chemotherapy · 2022Article
- Structural equation modelling the relationship between anti-fungal prophylaxis and Pseudomonas bacteremia in ICU patients.Intensive care medicine experimental · 2022Article
- Article
- Article
- Review
- Respiratory Tract Colonization byClinical pulmonary medicine · 2018Article
- The significance of Candida in the human respiratory tract: our evolving understanding.Pathogens and disease · 2017Review
- Candida Pneumonia: An Innocent Bystander or a Silent Killer?Medical principles and practice : international journal of the Kuwait University, Health Science CentreReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn critically ill patients, Candida spp. can often be identified in pulmonary samples. The impact of prompt antifungal therapy in these patients is unknown.
methodsIn this retrospective study, 500 adult patients with pulmonary Candida spp. colonization admitted to the intensive care unit (ICU) between 2010 and 2012 were included. The patients were analyzed according to whether or not they received antifungal therapy, which was administered at the discretion of the attending physician. Logistic regression analysis was performed to investigate the impact of antifungal therapy on hospital mortality and new onset of ventilator-associated pneumonia. In a stepwise backward elimination, the impact of age, cancer as an underlying disease, Simplified Acute Physiology Score (SAPS) II, and Sequential Organ Failure Assessment (SOFA) score were considered.
resultsAfter excluding 178 patients with multifocal Candida spp., isolated pulmonary Candida spp. colonization was found in 322 patients (cohort 1). Pre-existing pneumonia was found in 147/322 patients. Out of the remaining 175 patients (cohort 2), 44 patients received any antifungal therapy, and 131 were defined as the control group. Patients who received antifungal therapy had higher hospital mortality (50 vs. 30 %, p = 0.02) and pneumonia rates (47.7 vs. 16.8 %; p < 0.001) than those who did not. In Cox regression analysis, antifungal therapy was not independently associated with favorable outcome (mortality: odds ratio 0.854 (95 % CI 0.467-1.561); new pneumonia: 1.048 (0.536-2.046)), but SAPS II and SOFA score were significantly (p < 0.05) independent covariates for worse outcome.
conclusionsIn critically ill patients with pulmonary Candida spp. colonization, antifungal therapy may not have an impact on the incidence of new pneumonia or in-hospital mortality after adjustment for confounders.
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