The impact of real life treatment strategies for Candida peritonitis—A retrospective analysis

Summary Candida species are commonly detected isolates from abdominal foci. The question remains as to who would benefit from early empiric treatment in cases of Candida peritonitis. This study collected real‐life data on critically ill patients with Candida peritonitis to estimate the relevance of...

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Bibliographic Details
Published in:Mycoses 2017-07, Vol.60 (7), p.440-446
Main Authors: Dubler, S., Laun, M., Koch, C., Hecker, A., Weiterer, S., Siegler, B. H., Röhrig, R., Weigand, M. A., Lichtenstern, C.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Candida
Candida - classification
Candida - isolation & purification
candidaemia
Candidemia
Candidiasis
Candidiasis - drug therapy
Candidiasis - mortality
Critical Illness
Female
Humans
intensive care
Intensive Care Units
Liver diseases
Male
Middle Aged
Morbidity
Mortality
Peritonitis
Peritonitis - drug therapy
Peritonitis - mortality
Retrospective Studies
surgical treatment
Survival Analysis
Treatment Outcome
Young Adult
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Summary:Summary Candida species are commonly detected isolates from abdominal foci. The question remains as to who would benefit from early empiric treatment in cases of Candida peritonitis. This study collected real‐life data on critically ill patients with Candida peritonitis to estimate the relevance of the chosen treatment strategy on the outcome of these patients. One hundred and thirty‐seven surgical intensive care unit (ICU) patients with intra‐abdominal invasive Candidiasis were included in the study. Fifty‐six patients did not get any antifungal agent. Twenty‐nine patients were empirically treated, and 52 patients were specifically treated. In the group without, with empiric and with specific antifungal treatment, the 30‐day mortality rate was 33.9, 48.3 and 44.2 respectively. Candida albicans was the most frequently found species. Seven patients in the specific treatment group and one patient in the empiric treatment group emerged with candidaemia. Age, leucocyte count, APACHE II Score and acute liver failure were independent predictors of 30‐day mortality in patients with Candida peritonitis. Not all patients with Candida peritonitis received antifungal treatment in real clinical practice. Patients with higher morbidity more often got antifungals. Early empirical therapy has not been associated with a better 30‐day mortality.
ISSN:0933-7407
1439-0507
DOI:10.1111/myc.12615