Echinocandins versus Amphotericin B Against Candida tropicalis Fungemia in Adult Hematological Patients with Neutropenia: A Multicenter Retrospective Cohort Study

is the most common non-albicans species identified in immunocompromised patients, which often appears with high mortality. However, data on the outcomes of treatment for fungemia in patients with neutropenia remain limited. In the present study, 90 neutropenic adult patients with proven fungemia, wh...

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Bibliographic Details
Published in:Infection and drug resistance 2020-01, Vol.13, p.2229-2235
Main Authors: You, Liangshun, Yao, Cunying, Yang, Fan, Yang, Qing, Lan, Jianping, Song, Xiaolu, Shen, Jianping, Sheng, Xianfu, Chen, Xiaohui, Tang, Huifen, Jiang, Huifang, Wu, Haiying, Qian, Shenxian, Meng, Haitao
Format: Article
Language:English
Subjects:
Amphotericin B
Analysis
Antifungal agents
Antiparasitic agents
Candida tropicalis
candidemia
Care and treatment
Caspofungin
Catheters
China
Clinical outcomes
Cohort analysis
Echinocandins
Fever
Fungemia
Health aspects
hematological malignancy
Hematology
Hospitals
Immunocompromised hosts
Infections
Medical prognosis
Medical research
Mortality
Mycoses
Neutropenia
Original Research
Patients
Risk factors
Survival
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Summary:is the most common non-albicans species identified in immunocompromised patients, which often appears with high mortality. However, data on the outcomes of treatment for fungemia in patients with neutropenia remain limited. In the present study, 90 neutropenic adult patients with proven fungemia, who received initial antifungal therapy, were retrospectively analyzed. These results revealed that the overall 8-day and 30-day mortality among patients in the entire data set were 22.2% and 33.3%, respectively. However, there was no significant difference between the survival and death group, in terms of baseline characteristics. The univariate analysis of risk factors identified the treatment with azole as a predictor of mortality, while treatments that containing amphotericin B were associated with reduced mortality. In addition, the survival rate on day 30 was observed in 60.7% (17/28) of patients who were initially treated with echinocandins, while this was observed in 86.4% (19/22, 0.039) and 100% (13/13, 0.024) of patients treated with amphotericin B plus echinocandins and amphotericin B, respectively. These data indicate for the first time that the initial therapy with amphotericin B-based agents was associated with a better survival rate and could be assessed as the optimal strategy for the treatment of fungemia in patients with neutropenia.
ISSN:1178-6973
1178-6973
DOI:10.2147/IDR.S258744