Echinocandins Versus Azoles for Candidemia Treatment

Echinocandins Versus Azoles as First-line Therapy for the Treatment of Candidemia in Intensive Care Units

Candidemia is the most frequent invasive fungal disease in intensive care units (ICUs). It remains a major health concern, considering its attributable mortality up to 40% in critically ill patients. Successful clinical outcome requires early diagnosis and effective antifungal therapy. Guidelines for the treatment of candidemia were published by the Infectious Diseases Society of America (IDSA) and the European Society of Clinical Microbiology and Infectious Diseases (ESCMID). According to these guidelines, echinocandins are the preferred first-line therapy for candidemia in critically ill patients. Considering the bibliography supporting this statement, the place of triazoles still needs to be defined in candidemia therapeutic arsenal. In this context, we are setting up a retrospective cohort study using Hospital database to compare the efficacy of echinocandins and azoles for the treatment of candidemia in intensive care units.

Inclusion Criteria:

• Patients who had a diagnosis of candidemia during ICU stay and were treated with echinocandins or azoles

Exclusion Criteria:

• Patients with neutropenia
• Patients without antifungal treatment
• Patients who received antifungal therapy for more than two days before candidemia diagnosis
• Patients receiving liposomal amphotericin b or multiple antifungal agents as first-line therapy
• Patients who received less than 4 days of antifungal therapy after candidemia diagnosis