ArticleBMC infectious diseases2025
Empirical versus pre-emptive antifungal therapies for invasive fungal infections in critically ill patients.
Article in BMC infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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
1 citing paper in PubMed.
- Early-Onset Candidemia in Adult Intensive Care Units.Diagnostics (Basel, Switzerland) · 2025Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
Abstract
backgroundThe initiation strategy of antifungal therapy (AT) is among the most discussed practices for patients vulnerable to invasive fungal infections (IFI). In low-resource countries, there are also no appropriate consensus or guidelines for this issue. Given this clinical gap, we aimed to investigate the use of empirical and pre-emptive therapy in an Asian intensive care setting.
methodsWe conducted a retrospective cohort study (timeframe 2019-2020) on critically ill adults receiving systemic antifungals for ≥ 3 days. The exposure was empirical or pre-emptive therapy of systemic antifungals. The primary outcome was IFI-related mortality (in percentage, including in-hospital death or discharge/transfer with death prognosis). The secondary outcomes included overall rationale of AT (in percentage) and length of AT (LoAT, in days). We used logistic and linear regression to investigate the outcomes and reported the estimates with the 95% confidence interval (95% CI).
resultsDuring a median follow-up of 27 days, among 157 included patients (median age 68, 48.4% being female), we recorded 77 deaths (49.0% [95% CI 41.0-57.1%]) that were related to IFI (60 [51.7%] in the empirical group; 17 [41.5%] in the pre-emptive group; adjusted odds ratio of IFI-related mortality 1.86 [95% CI 0.74 to 4.63; p = 0.184]). The overall rationale of AT was at 45.2% (95% CI 37.2-53.4%; 41.4% [95% CI 32.3-50.9%] in the empirical group; 56.1% [95% CI 40.0-71.5%] in the pre-emptive group; adjusted odds ratio of receiving rational AT: 0.75 [95% CI 0.31 to 1.87]). The median LoAT was 8 days (IQR 6-14; 8 days [IQR 6-13.3] in the empirical group; 9 days [IQR 6-14] in the pre-emptive group; adjusted mean difference - 1.1 days [95% CI -3.2 to 1.0]).
conclusionAmong critically ill patients on systemic antifungals for ≥ 3 days, the proportion of IFI-related mortality was high. The overall rationale of AT was at a low level, with the median LoAT lower than the generally recommended duration of at least 14 days. There were no significant differences in IFI-related mortality, overall rationale of AT, and LoAT between those receiving empirical and pre-emptive therapy. CLINICAL TRIAL NUMBER: Not applicable.
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.