ArticleMediterranean journal of hematology and infectious diseases2021
Timing for Step-Down Therapy of Candidemia in Non-Neutropenic Patients: An International Multi-Center Study.
Article in Mediterranean journal of hematology and infectious diseases, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 9 citations in OpenAlex.
- Comparison of virulence factors between invasive and non-invasive clinical isolates ofCurrent medical mycology · 2025Article
- Guideline Adherence and Outcomes of Patients with Candidemia in Brazil.Journal of fungi (Basel, Switzerland) · 2024Article
- Epidemiological Assessment and Risk Factors for Mortality of Bloodstream Infections byJournal of fungi (Basel, Switzerland) · 2024Article
- Article
- Evaluation of the Therapeutic Effect of 15 ppm Silver Nanoparticle Spray Compared to Clotrimazole 1% on Candida Vaginitis: A Randomized Controlled Clinical Trial.Journal of family & reproductive health · 2023Article
- Molecular diagnosis, phylogenetic analysis, and antifungal susceptibility profiles of Candida species isolated from neutropenic oncological patients.BMC infectious diseases · 2023Article
- Clinical characteristics and prognostic risk factors of candidemia in non-neutropenic patients: a retrospective cohort study.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2023Article
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Authors and funding
12 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCandida bloodstream infection (BSI) remains one of the leading causes of BSI in critically ill and immunosuppressed cancer patients. In light of the changing epidemiology and rising resistant species, duration of treatment and appropriate timing of stepdown therapy from intravenous (IV) to oral antifungal agents are crucial for utmost disease control and overall survival.
methodWe performed a multicenter retrospective study, with 119 non-neutropenic patients enrolled from four different medical institutions in Brazil, Lebanon, Spain and the United States, to assess the duration of IV therapy and appropriate time to step-down to oral therapy in adult patients, 14 years of age and older, with documented candidemia. The analysis was done using the statistical program R and SAS v9.4. Descriptive statistics are presented as frequencies and tables and the Fisher exact test was used to test the association between the categorical variables: organism, cancer, country, antifungal drug and duration of therapy, and time of step-down.
results
conclusionOur data support the IDSA guidelines in that the total duration of treatment for candidemia should be at least 14 days after a negative blood culture. However, in non-neutropenic cancer patients with candidemia, a step-down to oral azole therapy can safely take place early (within 4 days of initiating IV therapy) as long as the patient had clinical and microbiologic resolution of the bloodstream infections.
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