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Early Empirical Anidulafungin Reduces the Prevalence of Invasive Candidiasis in Critically Ill Patients: A

Md Jahidul Hasan1, Sharmind Neelotpol2, Raihan Rabbani3

  • 1Clinical Pharmacy Service, Department of Pharmacy, Square Hospitals Ltd, Dhaka, Bangladesh.

Journal of Critical Care Medicine (Universitatea De Medicina Si Farmacie Din Targu-Mures)
|August 11, 2022
PubMed
Abstract

Insights

Early empirical anidulafungin significantly reduced invasive candidiasis and mortality in critically ill patients. This antifungal therapy improved outcomes, including faster ICU discharge rates.

Area of Science:

  • Critical Care Medicine
  • Infectious Diseases
  • Pharmacology

Background:

  • Invasive candidiasis (IC) presents a significant mortality risk in critically ill patients.
  • Empirical antifungal use, particularly echinocandins like anidulafungin, is an emerging strategy in intensive care units (ICUs).

Purpose of the Study:

  • To evaluate the impact of empirical anidulafungin on the incidence of invasive candidiasis in ICU patients.
  • To assess the effect of early anidulafungin administration on mortality and ICU discharge rates.

Main Methods:

  • A retrospective case-control study involving 149 patients with sepsis and/or septic shock and bacterial pneumonia.
  • Patients were divided into two groups: 'NEAT group' (no empirical anidulafungin) and 'EAT group' (early empirical anidulafungin therapy within 6 hours of ICU admission).

Main Results:

  • The EAT group showed significantly lower IC incidence (5.19%) compared to the NEAT group (29.17%) (p=0.001).
  • 30-day all-cause mortality was lower in the EAT group (10.39%) versus the NEAT group (19.44%) (p=0.04).
  • Patients receiving early anidulafungin had higher ICU discharge rates within 10 days.

Conclusions:

  • Early empirical anidulafungin administration effectively reduces the risk of invasive candidiasis in critically ill patients.
  • This strategy also lowers 30-day all-cause mortality and facilitates earlier ICU discharge.
Keywords:
Candida pneumoniaCandida urinary tract infectionanidulafungincritically ill patientinvasive candidiasis

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