ReviewCritical care (London, England)2023
Critical appraisal beyond clinical guidelines for intraabdominal candidiasis.
Review in Critical care (London, England), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
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
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 30 citations in OpenAlex.
- Brazilian guidelines for the diagnosis and treatment of candidemia and invasive candidiasis in adults and children.The Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious DiseasesGuideline
- IFUCISTRATEGY: A Spanish Survey on the Management of Invasive Fungal Infection (IFI) in Critically Ill Patients.Journal of fungi (Basel, Switzerland) · 2026Article
- Article
- Temporal changes in fungal epidemiology in ICU post-operative peritonitis cases.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026Article
- Perioperative management of septic peritonitis in small animals: A review.Veterinary surgery : VS · 2026Review
- Diagnosis and management of invasive candidiasis in critically ill patients: SIAARTI multidisciplinary statement.Journal of anesthesia, analgesia and critical care · 2025Review
- Personalized Approaches to Patients with Intra-Abdominal Infections.Journal of clinical medicine · 2025Review
- Review on the management of intra-abdominal candidiasis.Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2025Review
- Candidemia: An Update on Epidemiology, Risk Factors, Diagnosis, Susceptibility, and Treatment.Pathogens (Basel, Switzerland) · 2025Review
- Distribution and drug resistance analysis of pathogens in early-stage digestive tract perforation complicated with peritonitis.Scientific reports · 2025Article
- Management of Intra-Abdominal Candidiasis in Intensive Care Setting: A Narrative Review.Journal of fungi (Basel, Switzerland) · 2025Review
- Role of liposomal amphotericin B in intensive care unit: an expert opinion paper.Journal of anesthesia, analgesia and critical care · 2025Review
- Efficacy and Safety of Amphotericin B Colloidal Dispersion for Patients with Invasive Fungal Disease and Febrile Neutropenia: A Registry-Based, Multicenter, Retrospective, Real-World Study.Infection and drug resistance · 2025Article
- Empirical antifungal therapy for health care-associated intra-abdominal infection: a retrospective, multicentre and comparative study.Annals of intensive care · 2024Article
- Management of intra-abdominal infections: recommendations by the Italian council for the optimization of antimicrobial use.World journal of emergency surgery : WJES · 2024Review
- Intra-abdominal infections survival guide: a position statement by the Global Alliance For Infections In Surgery.World journal of emergency surgery : WJES · 2024Review
- Invasive candidiasis.Nature reviews. Disease primers · 2024Review
- Combination of serum and peritoneal 1.3-beta-D-glucan can rule out intra-abdominal candidiasis in surgical critically ill patients: a multicenter prospective study.Critical care (London, England) · 2023Article
- Pharmacokinetic and pharmacodynamic considerations for antifungal therapy optimisation in the treatment of intra-abdominal candidiasis.Critical care (London, England) · 2023Review
- A Narrative Review of Invasive Candidiasis in the Intensive Care Unit.Therapeutic advances in pulmonary and critical care medicineReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 11 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundRegardless of the available antifungals, intraabdominal candidiasis (IAC) mortality continues to be high and represents a challenge for clinicians. MAIN BODY: This opinion paper discusses alternative antifungal options for treating IAC. This clinical entity should be addressed separately from candidemia due to the peculiarity of the required penetration of antifungals into the peritoneal cavity. Intraabdominal concentrations may be further restricted in critically ill patients where pathophysiological facts alter normal drug distribution. Echinocandins are recommended as first-line treatment in guidelines for invasive candidiasis. However, considering published data, our pharmacodynamic analysis suggests the required increase of doses, postulated by some authors, to attain adequate pharmacokinetic (PK) levels in peritoneal fluid. Given the limited evidence in the literature on PK/PD-based treatments of IAC, an algorithm is proposed to guide antifungal treatment. Liposomal amphotericin B is advocated as first-line therapy in patients with sepsis/septic shock presenting candidemia or endophthalmitis, or with prior exposure to echinocandins and/or fluconazole, or with infections by Candida glabrata. Other situations and alternatives, such as new compounds or combination therapy, are also analysed.
conclusionThere is a critical need for more robust clinical trials, studies examining patient heterogeneity and surveillance of antifungal resistance to enhance patient care and optimise treatment outcomes. Such evidence will help refine the existing guidelines and contribute to a more personalised and effective approach to treating this serious medical condition. Meanwhile, it is suggested to broaden the consideration of other options, such as liposomal amphotericin B, as first-line treatment until the results of the fungogram are available and antifungal stewardship could be implemented to prevent the development of resistance.
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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.