ArticleOpen forum infectious diseases2026
Challenging the Concept of Uncomplicated Candidemia for Shorter Courses of Antifungal Therapy.
Article in Open forum infectious diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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4 authors.
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Abstract
Background: A recent proposal introduced criteria to distinguish uncomplicated from complicated candidemia and identify patients who might be candidates for a shortened (7-day) course of antifungal therapy. We evaluated the feasibility and potential impact of this strategy in a real-world cohort. Methods: This retrospective study included patients with candidemia at Lausanne University Hospital (2015-2024). We estimated the sample size required for a randomized non-inferiority trial comparing 7 vs 14 days of therapy for episodes with uncomplicated candidemia and the reduction in antifungal treatment days under a hypothetical 7-day treatment strategy. Results: Among 314 episodes of candidemia, 103 (33%) were classified as uncomplicated. Of the 264 (84%) episodes surviving beyond the first 5 days without limitation of care, 30-day mortality was lower in uncomplicated than complicated candidemia (7% vs 20%; Conclusions: Uncomplicated candidemia accounted for only one-third of episodes, and abbreviated therapy would yield a modest reduction in antifungal exposure. The large sample size required and limited stewardship benefit suggest that a randomized trial would be challenging to conduct.
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