ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2021
Treatment Practices for Adults With Candidemia at 9 Active Surveillance Sites-United States, 2017-2018.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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13 citing papers in PubMed, 19 citations in OpenAlex.
- Clinical safety and efficacy of novel antifungal, fosmanogepix, for the treatment of candidaemia: results from a Phase 2 trial.The Journal of antimicrobial chemotherapy · 2023Trial
- Candida glabrata Emerges as the Most Common Cause of Candidemia: Analysis of a Large Hospital-Based Database, United States, 2016-2024.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Article
- Yeast identification, antifungal susceptibility testing, andJournal of clinical microbiology · 2026Article
- Heterogeneity ofMicrobiology spectrum · 2025Article
- Population-Based Active Surveillance for Culture-Confirmed Candidemia - 10 Sites, United States, 2017-2021.Morbidity and mortality weekly report. Surveillance summaries (Washington, D.C. : 2002) · 2025Article
- Beyond Conventional Antifungals: Combating Resistance Through Novel Therapeutic Pathways.Pharmaceuticals (Basel, Switzerland) · 2025Review
- Rapid and sensitive identification ofFrontiers in cellular and infection microbiology · 2025Article
- Clinical manifestations and treatment of candidemia caused by different Candida species: a retrospective study.BMC infectious diseases · 2024Article
- A Membrane-Targeted Photosensitizer Prevents Drug Resistance and Induces Immune Response in Treating Candidiasis.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2023Article
- Candida auris‒Associated Hospitalizations, United States, 2017-2022.Emerging infectious diseases · 2023Article
- Recurrent Candidemia: Trends and Risk Factors Among Persons Residing in 4 US States, 2011-2018.Open forum infectious diseases · 2022Article
- Antifungal Resistance and the Role of New Therapeutic Agents.Current infectious disease reports · 2022Review
- A Cecropin-4 Derived Peptide C18 InhibitsFrontiers in microbiology · 2022Article
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Authors and funding
22 authors at 9 institutions in 1 country.
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Abstract
backgroundCandidemia is a common opportunistic infection causing substantial morbidity and mortality. Because of an increasing proportion of non-albicans Candida species and rising antifungal drug resistance, the Infectious Diseases Society of America (IDSA) changed treatment guidelines in 2016 to recommend echinocandins over fluconazole as first-line treatment for adults with candidemia. We describe candidemia treatment practices and adherence to the updated guidelines.
methodsDuring 2017-2018, the Emerging Infections Program conducted active population-based candidemia surveillance at 9 US sites using a standardized case definition. We assessed factors associated with initial antifungal treatment for the first candidemia case among adults using multivariable logistic regression models. To identify instances of potentially inappropriate treatment, we compared the first antifungal drug received with species and antifungal susceptibility testing (AFST) results from initial blood cultures.
resultsAmong 1835 patients who received antifungal treatment, 1258 (68.6%) received an echinocandin and 543 (29.6%) received fluconazole as initial treatment. Cirrhosis (adjusted odds ratio = 2.06; 95% confidence interval, 1.29-3.29) was the only underlying medical condition significantly associated with initial receipt of an echinocandin (versus fluconazole). More than one-half (n = 304, 56.0%) of patients initially treated with fluconazole grew a non-albicans species. Among 265 patients initially treated with fluconazole and with fluconazole AFST results, 28 (10.6%) had a fluconazole-resistant isolate.
conclusionsA substantial proportion of patients with candidemia were initially treated with fluconazole, resulting in potentially inappropriate treatment for those involving non-albicans or fluconazole-resistant species. Reasons for nonadherence to IDSA guidelines should be evaluated, and clinician education is needed.
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