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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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Echinocandin group | Echinocandin group is the group of patients who received echinocandins as first-line therapy for candidemia |
| |
| Triazole group | Triazole group is the group of patients who received triazoles as first-line therapy for candidemia |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Echinocandin treatment | Drug | Patients received echinocandins as a first-line therapy after candidemia diagnosis according to the standard of care |
|
| Measure | Description | Time Frame |
|---|---|---|
| Comparison of all cause hospital mortality on day 90 between echinocandins and azoles | Comparison of all cause hospital mortality on day 90 between echinocandins and azoles | Mortality on day 90 after antifungal initiation |
| Measure | Description | Time Frame |
|---|---|---|
| Comparison of treatment success on day 30 between echinocandins and azoles. | Treatment success is defined as a complete response if the following two criteria were full-filled: survival and resolution of all attributable symptoms and signs of disease, and mycological success (documented clearance of pathogen from the blood). | Treatment success on day 30 after antifungal initiation |
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Inclusion Criteria:
Exclusion Criteria:
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Patients with a diagnosis of candidemia during their ICU stay
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hospices Civils de Lyon, Hôpital de la Croix-Rousse | Lyon | 69004 | France |
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| ID | Term |
|---|---|
| D058387 | Candidemia |
| ID | Term |
|---|---|
| D058365 | Candidiasis, Invasive |
| D002177 | Candidiasis |
| D009181 | Mycoses |
| D001423 | Bacterial Infections and Mycoses |
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| Triazole treatment | Drug | Patients received triazoles as a first-line therapy after candidemia diagnosis according to the standard of care. Candidemia was defined as at least one blood culture positive for Candida. |
|
| D007239 |
| Infections |
| D000072742 | Invasive Fungal Infections |
| D016469 | Fungemia |
| D018805 | Sepsis |
| D018746 | Systemic Inflammatory Response Syndrome |
| D007249 | Inflammation |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |