Impact of select risk factors on treatment outcome in adults with candidemia
| Autor: | Richard H. Drew, Dustin Wilson, Brandon K. Hill |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
mesh:Cohort Studies
medicine.medical_treatment mesh:Neutropenia Pharmaceutical Science lcsh:RS1-441 Pharmacy law.invention Cohort Studies law mesh:Renal Replacement Therapy Treatment Failure Fluconazole Original Research Candida Intensive care unit Hospitals Renal Replacement Therapy Intensive Care Units Treatment Outcome mesh:Treatment Outcome medicine.drug Cohort study medicine.medical_specialty Neutropenia mesh:North Carolina mesh:Fluconazole lcsh:Pharmacy and materia medica mesh:Intensive Care Units Internal medicine mesh:Treatment Failure medicine North Carolina Renal replacement therapy University mesh:Hospitals business.industry lcsh:RM1-950 Candidemia Odds ratio mesh:Candida medicine.disease Regimen lcsh:Therapeutics. Pharmacology Concomitant Hospitals University mesh:Candidemia business mesh:University |
| Zdroj: | Pharmacy Practice (Granada) v.17 n.3 2019 SciELO España. Revistas Científicas Españolas de Ciencias de la Salud instname Pharmacy Practice, Vol 17, Iss 3, p 1561 (2019) Pharmacy Practice Pharmacy Practice (Granada), Volume: 17, Issue: 3, Article number: 1561, Published: 25 NOV 2019 |
| Popis: | Background: Studies examining relationships between patient-related factors and treatment outcome in patients with candidemia are limited and often based on all-cause mortality. Objective: Our purpose was to examine the impact of concurrent renal replacement therapy (RRT) and other pre-specified factors on treatment outcome among adults with candidemia. Methods: This Institutional Review Board (IRB)-approved, single-center, case-cohort study included patients over 18 years of age admitted to Duke University Hospital between Jun 1, 2013 and Jun 1, 2017 with a blood culture positive for Candida spp. Treatment-, patient-, and disease-specific data were collected, and outcome (success/failure) determined 90 days after the index culture. An odds ratio (OR) and 95% confidence interval (95%CI) were calculated for the following during therapy: receipt of RRT, fluconazole monotherapy regimen, intensive care unit (ICU) stay, and neutropenia. Results: Among the 112 encounters (from 110 unique patients) included, treatment failure occurred in 8/112 (7.1%). Demographics were comparable between outcome groups. Among 12 patients receiving concomitant RRT, only 1 patient failed therapy. With regard to treatment failure, no significant differences were observed with RRT (OR, 1.21; 95%CI, 0.14 – 10.75), fluconazole monotherapy regimen (OR, 1.59; 95%CI, 0.3-8.27), ICU stay (OR, 1.43; 95%CI, 0.32-6.29), and neutropenia (0 treatment failures). Conclusions: Treatment failure, receipt of concomitant RRT, and neutropenia were infrequent in patients undergoing treatment for candidemia. In our cohort, exposure to RRT, a fluconazole monotherapy regimen, ICU stay, or neutropenia during treatment did not impact treatment outcome. |
| Databáze: | OpenAIRE |
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