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Multiple organ failure might be an indication for prophylactic antifungal therapy in acute pancreatitis

Caihong Ning1,2,3, Shuai Zhu1,2,3, Shuyi Zhou1,2,3

  • 1Department of Pancreatic Surgery, Xiangya Hospital, Central South University, 87 Xiangya Rd, Changsha, 410008, Hunan, People's Republic of China.

Infection
|May 14, 2021
PubMed
Abstract

Insights

Identifying risk factors for intra-abdominal fungal infections in acute pancreatitis is crucial. Multiple organ failure emerged as the sole independent predictor, suggesting its potential role in guiding prophylactic antifungal therapy decisions.

Area of Science:

  • Gastroenterology and Hepatology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Prophylactic antifungal treatment in acute pancreatitis (AP) remains controversial.
  • Identifying risk factors for intra-abdominal fungal infection (AFI) is key to resolving this debate.

Purpose of the Study:

  • To identify independent risk factors for intra-abdominal fungal infection (AFI) in patients with acute pancreatitis (AP).
  • To inform guidelines and clinical practice regarding prophylactic antifungal therapy in AP.

Main Methods:

  • Retrospective cohort study of 826 AP patients from January 2014 to December 2019.
  • Analysis focused on identifying risk factors associated with the development of AFI.

Main Results:

  • AFI occurred in 1.2% of AP patients, with a significantly higher incidence in severe AP (SAP) (10.3%) compared to moderately severe AP (MSAP) (0.8%) and mild AP (0%).
  • SAP patients with AFI were more likely to experience multiple organ failure (MOF), prolonged organ failure (>1 week), and early surgical intervention (<1 week).
  • Multivariable analysis identified MOF as the only independent risk factor for AFI (OR=14.3; 95% CI 1.2-173.8).

Conclusions:

  • Multiple organ failure (MOF) may serve as a critical indicator for considering prophylactic antifungal therapy in acute pancreatitis patients.
  • These findings could help refine treatment strategies and reduce antifungal-related complications.
Keywords:
Acute pancreatitisIntra-abdominal fungal infectionMultiple organ failure

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