ArticleOpen forum infectious diseases2021
Early Stepdown From Echinocandin to Fluconazole Treatment in Candidemia: A Post Hoc Analysis of Three Cohort Studies.
Article in Open forum infectious diseases, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 13 papers.
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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.
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.
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Who cites it
13 citing papers in PubMed, 18 citations in OpenAlex.
- Invasive Candidiasis in Critically Ill Patients: Fundamental Concepts and Future Directions.Chest · 2026Review
- Early de-escalation of antifungal treatment in critically ill immunocompromised patients with proven or probable invasive candidiasis: A retrospective multicentre study.Annals of intensive care · 2026Article
- French intensive care physicians' practices for the management of high-risk patients with invasive candidiasis: results from the multicenter INSPIRE survey.Annals of intensive care · 2026Article
- Antifungal treatment strategies and their impact on resistance development in clinical settings.The Journal of antimicrobial chemotherapy · 2025Review
- Fluconazole step-down therapy versus echinocandins for the treatment of Candida glabrata invasive candidiasis with candidaemia.The Journal of antimicrobial chemotherapy · 2025Article
- Invasive Candidiasis in the Intensive Care Unit: Where Are We Now?Journal of fungi (Basel, Switzerland) · 2025Review
- Review
- Unresolved issues in the diagnosis of catheter related candidemia: A position paper.Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2024Review
- Observational
- Invasive candidiasis: current clinical challenges and unmet needs in adult populations.The Journal of antimicrobial chemotherapy · 2023Review
- Antifungal stewardship in critically ill patients.Intensive care medicine · 2023Article
- Impact of the Disk Diffusion Test on Fluconazole De-Escalation in Patients with Candidemia.Journal of fungi (Basel, Switzerland) · 2022Article
- Impact of Generic Entry on Hospital Antimicrobial Use: A Retrospective Quasi-Experimental Interrupted Time Series Analysis.Antibiotics (Basel, Switzerland) · 2021Article
Corrections and comments
- Erratum issued
Authors and funding
24 authors at 12 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThere are no clear criteria for antifungal de-escalation after initial empirical treatments. We hypothesized that early de-escalation (ED) (within 5 days) to fluconazole is safe in fluconazole-susceptible candidemia with controlled source of infection.
methodsThis is a multicenter post hoc study that included consecutive patients from 3 prospective candidemia cohorts (2007-2016). The impact of ED and factors associated with mortality were assessed.
resultsOf 1023 candidemia episodes, 235 met inclusion criteria. Of these, 54 (23%) were classified as the ED group and 181 (77%) were classified as the non-ED group. ED was more common in catheter-related candidemia (51.9% vs 31.5%;
conclusionsEarly de-escalation is a safe strategy in patients with candidemia caused by fluconazole-susceptible strains with controlled source of bloodstream infection and hemodynamic stability. These results are important to apply antifungal stewardship strategies.
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