International guidelines: the need to standardize the management of candidaemia

Jack, Laura; Bal, Abhijit M.; Harte, Sam; Collier, Andrew

doi:10.1080/23744235.2016.1207251

Cited by 9 publications

(6 citation statements)

References 13 publications

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“…In particular, uncomplicated S. aureus bacteremia requires at least 14 days of therapy, while complicated bacteremia requires treatment as an endovascular infection with 6 weeks of therapy. Uncomplicated bacteremia has been defined as: (1) exclusion of endocarditis, (2) no implanted prostheses, (3) negative results of follow-up blood cultures drawn 2-4 days after the initial set, (4) defervescence within 72 h after the initiation of effective antibiotic therapy, and (5) no evidence of metastatic infection [104].Patients with candidemia (whether or not catheter-associated) and deep Candida infections, whether or not associated with sepsis, require more prolonged therapy [105,205]. Highly resistant gramnegative pathogens with marginal sensitivity to utilized antimicrobials maybe slow to clear and represent another example.…”

Section: We Recommend Daily Assessment For De-escalation Of Antimicromentioning

confidence: 99%

Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016

Rhodes

Evans

Alhazzani

et al. 2017

Critical Care Medicine

2,380

814

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Substantial agreement exists among a large cohort of international experts regarding many strong recommendations for the best care of patients with sepsis. Although a significant number of aspects of care have relatively weak support, evidence-based recommendations regarding the acute management of sepsis and septic shock are the foundation of improved outcomes for these critically ill patients with high mortality.

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Section: We Recommend Daily Assessment For De-escalation Of Antimicromentioning

confidence: 99%

Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016

Rhodes

Evans

Alhazzani

et al. 2017

Critical Care Medicine

2,380

814

View full text Add to dashboard Cite

show abstract

“…With regard to the initial therapeutic scheme, we observed that, in only 60.1% of the cases, an echinocandin was the initial drug of choice. Several guides and studies recommend echinocandins as a first-line drug to start treatment, with an A-1 level of evidence, based on a systematic review that demonstrated lower mortality in the group that started treatment with echinocandins versus comparator groups [1][2][3]25,31]. Therefore, it is necessary to change prescribing habits and promote continued education for physicians, targeting echinocandins as initial therapy for proven cases of candidemia.…”

Section: Discussionmentioning

confidence: 99%

Epidemiological Assessment and Risk Factors for Mortality of Bloodstream Infections by Candida sp. and the Impact of the COVID-19 Pandemic Era

Araujo,

de Almeida Junior,

Magri

et al. 2024

JoF

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Candidemia is one of the healthcare-associated infections that has high mortality. The risk factors that predispose a patient to develop this infection are mostly found in patients of greater severity and COVID-19 contributes to the risk of death. The aim of this study is to evaluate epidemiological characteristics and risk factors for mortality in patients with candidemia before and during the COVID-19 pandemic era. This is a retrospective study conducted at Instituto Central from 2016 to 2020 of patients with candidemia that were evaluated for demographic data, medical history, risk factors, microbiological data, therapeutic measures, complementary exams, device management, and outcome defined by 30-day mortality. A total of 170 episodes were included (58.2% males; mean age of 56 years). The overall incidence density of candidemia per 1000 admissions and per 1000 patient-days was 1.17 and 0.17, respectively, with an increase of 38% in the year 2020. The use of a central venous catheter was the most prevalent (93.5%) condition, followed by the previous use of antibiotics (91.1%). Corticosteroid use ranked seventh (56.4%). C. albicans was responsible for 71 (41.7%) of the isolates, followed by C. tropicalis and C. glabrata, with 34 (20%) isolates each. Echinocandin was prescribed in 60.1% of cases and fluconazole in 37%. Echocardiography resulted in six (5.08%) cases of endocarditis and fundoscopy resulting in two (2.4%) endophthalmitis. The 30-day mortality was 93/170 (54.7%). The risk factors associated with mortality were age (OR 1.03, CI 95% 1.01–1.06), heart disease (OR 7.51, CI 95% 1.48–37.9), hemodialysis (OR 3.68, CI 95% 1.28–10.57), and use of corticosteroids (OR 2.83, CI 95% 1.01–7.92). The COVID-19 pandemic had an impact on the increase incidence of candidemia. The persistently high mortality highlights the need for better management strategies, control of risk factors, and guarantee of adequate treatment.

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“…A case was defined as adherent when eight prespecified key items belonging to the ESCMID recommendations were fulfilled. While some items are uniformly recognized by the main recommendations as being essential elements for the management of candidemia (early treatment, removal of the catheter), other items are not standardized (type of primary treatment, step-down therapy, funduscopic exam), leading to uncertainties in clinical decision-making [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…Compliance with recommendations is often weak in audit studies [ 10 ]. A few studies focused on adherence to the ESCMID candidemia management recommendations and found conflicting results, especially regarding their impact on mortality [ 11 , 12 , 13 , 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

Association between Following the ESCMID Guidelines for the Management of Candidemia and Mortality: A Retrospective Cohort Study

Maurille

Bonhomme

Briant

et al. 2022

JoF

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Objectives: The objective of this study was to evaluate the association between ESCMID adherence and 30-day mortality in candidemia. Methods: We performed a retrospective cohort study in two French tertiary-care hospitals. All patients with at least one positive blood culture (BC) for Candida spp. between January 2013 and December 2019 were included. An adherent case was defined as a candidemia case for which the treatment fulfilled a bundle of defined criteria based on the latest ESCMID recommendations. We explored factors associated with adherence to ESCMID recommendations in an unadjusted model, and we used a propensity score method to address potential channeling biases with regard to 30-day mortality. Results: During the study period, 165 cases of candidemia were included. Among the ESCMID criteria, funduscopic examination was not performed in 45% and neither was echocardiography in 31%, while the ESCMID criteria were fully implemented in 44 cases (27%). In the propensity score analysis, the all-cause 30-day mortality rate was significantly lower among adherent cases (3.4/36.6, 9%) than among nonadherent cases (42.4/119.5, 36%) (OR = 5.3 95% CI [1.6–17.1]). Conclusions: In our study, adherence to the bundle of criteria for candidemia management was associated with increased survival, supporting additional efforts to implement these recommendations.

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International guidelines: the need to standardize the management of candidaemia

Cited by 9 publications

References 13 publications

Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016

Surviving Sepsis Campaign: International Guidelines for Management of Sepsis and Septic Shock: 2016

Epidemiological Assessment and Risk Factors for Mortality of Bloodstream Infections by Candida sp. and the Impact of the COVID-19 Pandemic Era

Association between Following the ESCMID Guidelines for the Management of Candidemia and Mortality: A Retrospective Cohort Study

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