ArticleMycoses2021
Impact of tolerance to fluconazole on treatment response in Candida albicans bloodstream infection.
Article in Mycoses, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
31 citing papers in PubMed, 51 citations in OpenAlex.
- Parameters affecting the reliable measurement of fluconazole tolerance using disk diffusion assays withMicrobiology spectrum · 2026Article
- Emerging antifungal strategies against Candida albicans using metal-organic frameworks and novel therapeutics: Opportunities and challenges.Journal of food and drug analysis · 2026Review
- Article
- Interpretable Quantitative Structure-Activity Relationship (QSAR) for identification of potent antifungal activity agents towards Candida albicans ATCC 2091.Molecular diversity · 2026Article
- Peroxin Pex8 couples stress responses, antifungal tolerance, and virulence regulation inAntimicrobial agents and chemotherapy · 2026Article
- Stress-driven emergence of heritable non-genetic drug resistance.Research square · 2025Article
- Antifungal resistance: Emerging mechanisms and implications (Review).Molecular medicine reports · 2025Review
- Heterogeneity ofMicrobiology spectrum · 2025Article
- Impairing the interaction between Erg11 and cytochrome P450 reductase Ncp1 enhances azoles' antifungal activities.Nature communications · 2025Article
- Hotspot gene conversion between FKS1 and FKS2 in echinocandin resistant Candida glabrata serial isolates.npj antimicrobials and resistance · 2025Article
- Insight into the Mechanisms and Clinical Relevance of Antifungal Heteroresistance.Journal of fungi (Basel, Switzerland) · 2025Review
- Collateral sensitivity counteracts the evolution of antifungal drug resistance in Candida auris.Nature microbiology · 2024Article
- Step-wise evolution of azole resistance through copy number variation followed by KSR1 loss of heterozygosity in Candida albicans.PLoS pathogens · 2024Article
- Pitavastatin Calcium Confers Fungicidal Properties to Fluconazole by Inhibiting Ubiquinone Biosynthesis and Generating Reactive Oxygen Species.Antioxidants (Basel, Switzerland) · 2024Article
- Metabolic sensing tips the balance of drug tolerance in fungal meningitis.Nature microbiology · 2024Article
- An integrated transcriptomic and metabolomic approach to investigate the heterogeneousBiofilm · 2023Article
- Article
- Potential Implication of Azole Persistence in the Treatment Failure of Two Haematological Patients Infected withJournal of fungi (Basel, Switzerland) · 2023Article
- Review
- Fungal Drug Response and Antimicrobial Resistance.Journal of fungi (Basel, Switzerland) · 2023Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundTreatment of Candida albicans bloodstream infection with fluconazole is associated with significant mortality despite in vitro susceptibility to the drug.
objectivesWe sought to determine whether tolerance to fluconazole is predictive of treatment failure.
methodsWe reviewed patients with monomicrobial C albicans bloodstream infection who received primary monotherapy with fluconazole. Tolerance to fluconazole, defined as the fraction of growth above the MIC, was quantified using the disc diffusion assay and digital image analyses. Survival analyses were performed with host and treatment factors as predictive variables.
resultsAmong 44 patients included in the study, all-cause mortality was 29.5% at 30 days and 43.1% at 12 weeks. Forty-one isolates (93%) were susceptible to fluconazole (MIC50, 0.5 mg/L). Fluconazole tolerance was strongly associated with death for patients treated with fluconazole within 24 h of candidemia onset (33.3% vs 0%; p = .007), but not among patients whose treatment was started later. MIC did not correlate with survival, regardless of treatment delay. A Cox regression model including time to treatment, tolerance to fluconazole, fluconazole exposure and Pitt bacteraemia score provided good prediction of treatment outcome (area under the receiver-operator curve, 0.82).
conclusionsIn patients with C albicans bloodstream infection, tolerance testing was predictive of fluconazole efficacy if the drug was started early. Further study is required to validate the utility of this metric to guide treatment choices.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.