The association between fluconazole dose and MIC with mortality and persistence in candidemia

Ghanem-Zoubi, Nesrin; Qasum, Majd; Khoury, Johad; Zorbavel, Danny; Arnon, Merav; Geffen, Yuval

doi:10.1007/s10096-019-03611-1

Cited by 7 publications

(5 citation statements)

References 14 publications

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“…Some studies did report high rates of azole resistance (ranging from 20% to 60%), especially amongst non-sterile site isolates from middle-income settings. 29 , 41 , 58 , 71 , 42 , 60 This is alarming given that invasive disease is caused by commensal organisms. The highest rate of azole resistance in a study with exclusively blood-derived isolates was 10% resistance to voriconazole.…”

Section: Discussionmentioning

confidence: 99%

Candida albicans—A systematic review to inform the World Health Organization Fungal Priority Pathogens List

Parambath,

Dao,

Kim

et al. 2024

Medical Mycology

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Candida albicans is a common fungal pathogen and amongst the leading causes of invasive candidiasis globally. This systematic review examines the characteristics and global impact of invasive infections caused by C. albicans. We searched on PubMed and Web of Science for studies reporting on criteria such as mortality, morbidity, drug resistance, preventability, yearly incidence, and distribution/emergence during the period from 2016 to 2021. Our findings indicate that C. albicans is the most common Candida species causing invasive disease and that standard infection control measures are the primary means of prevention. However, we found high rates of mortality associated with infections caused by C. albicans. Furthermore, there is a lack of data on complications and sequelae. Resistance to commonly used antifungals remains rare. Although, whilst generally susceptible to azoles, we found some evidence of increasing resistance, particularly in middle-income settings—notably, data from low-income settings were limited. Candida albicans remains susceptible to echinocandins, amphotericin B, and flucytosine. We observed evidence of a decreasing proportion of infections caused by C. albicans relative to other Candida species, although detailed epidemiological studies are needed to confirm this trend. More robust data on attributable mortality, complications, and sequelae are needed to understand the full extent of the impact of invasive C. albicans infections.

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Section: Discussionmentioning

confidence: 99%

Candida albicans—A systematic review to inform the World Health Organization Fungal Priority Pathogens List

Parambath,

Dao,

Kim

et al. 2024

Medical Mycology

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“…In an observational study by Ghanem-Zoubi et al [47] which looked at the association between the AUC/MIC of fluconazole and clinical outcomes in patients with candidemia, the authors discovered that higher doses of fluconazole are needed to treat Candida sp. with high MICs.…”

Section: Application Of Pk/pd Concepts In Optimisation Of Antifungal mentioning

confidence: 99%

Challenges in Antifungal Therapy in Diabetes Mellitus

Lim

Sinnollareddy

Sime

2020

JCM

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Diabetic patients have an increased propensity to Candida sp. infections due to disease-related immunosuppression and various other physiological alterations. The incidence of candidiasis has increased in number over the years and is linked to significant morbidity and mortality in critically ill and immunosuppressed patients. Treatment of infection in diabetic patients may be complicated due to the various disease-related changes to the pharmacokinetics and pharmacodynamics (PK/PD) of a drug, including antifungal agents. Application of PK/PD principles may be a sensible option to optimise antifungal dosing regimens in this group of patients. Further studies on PK/PD of antifungals in patients with diabetes mellitus are needed as current data is limited or unavailable.

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“…Portanto, considerando a alta variabilidade inter e intraindividual dos pacientes e suas condições clínicas associadas, é possível que haja vieses de seleção importantes. (EUCAST, 2020;RODRÍGUEZ-TUDELA et al, 2007) De fato, nos estudos encontrados que avaliam desfechos, houve grande variabilidade populacional e não há padronização nos protocolos de estudos referentes às doses utilizadas, tempo de infusão e metodologia de avaliação da farmacocinética do fluconazol (BADDLEY et al, 2008;CLANCY et al, 2005;GHANEM-ZOUBI et al, 2019;PAI et. al, 2007;RODRÍGUES-TUDELA et al, 2007).…”

Section: No Entanto O European Commitee On Antimicrobial Susceptibili...unclassified

“…Entretanto, houve uma associação significativa da falha terapêutica com a presença de neutropenia moderada/grave e transplantes. -ZOUBI et al, 2019;PAI et al, 2007;RODRÍGUEZ-TUDELA et al, 2007).…”

Section: No Entanto O European Commitee On Antimicrobial Susceptibili...unclassified

“…Também não foi identificada diferença quando avaliado os índices dose/CIM e ASC ss 0-24h/CIM≥400. No entanto, este estudo traz uma estratificação de 32 pacientes com candidemia por Candida glabrata, em que foi detectada diferença significativa na ASC ss 0-24h /CIM entre os sobreviventes e não-sobreviventes(230 [77- 539] vs. 96 [75-164], p=0,008) e uma tendência a uma CIM menor(7 [7-14] vs. 16 [8-24], p=0,06)(GHANEM-ZOUBI et al, 2019).Frente à literatura encontrada é difícil estabelecer o índice de predição de efetividade ideal, mas o índice inicial de ASC ss 0-24h /CIM>25, mesmo com as limitações de um modelo animal, ainda se mostra robusto. No entanto, os trabalhos realizados com métodos estatísticos populacionais não podem ser desprezados, podem necessitar de doses maiores.…”

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Abordagem PK/PD para avaliar a efetividade do fluconazol nas infecções fúngicas causadas por >i<Candida spp.>/i< em pacientes queimados de UTI

Matsuno¹

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The association between fluconazole dose and MIC with mortality and persistence in candidemia

Cited by 7 publications

References 14 publications

Candida albicans—A systematic review to inform the World Health Organization Fungal Priority Pathogens List

Candida albicans—A systematic review to inform the World Health Organization Fungal Priority Pathogens List

Challenges in Antifungal Therapy in Diabetes Mellitus

Abordagem PK/PD para avaliar a efetividade do fluconazol nas infecções fúngicas causadas por >i<Candida spp.>/i< em pacientes queimados de UTI

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