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06:02
A Contemporary Warming/Restraining Device for Efficient Tail Vein Injections in a Murine Fungal Sepsis Model
Published on: November 6, 2020
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Surgical Infection Society Multi-Center Observational Study: Empiric Anti-Fungal Coverage after Non-Colonic
Andrea M Gochi1, Wardah Rafaqat2, Vahe Panossian2
1Department of Surgery, University of California San Francisco East Bay, Oakland, California, USA.
Surgical Infections
|May 13, 2025
Summary
Empiric antifungal use in non-colonic gastrointestinal perforations showed no benefit in reducing organ-space surgical site infections. Routine use is not recommended due to a lack of clinical advantage.
Area of Science:
- Gastroenterology
- Surgical Infections
- Pharmacology
Background:
- Empiric antifungal administration is common for non-colonic gastrointestinal perforations.
- Evidence supporting the benefit of empiric antifungals in these cases is limited.
Purpose of the Study:
- To evaluate the clinical benefit of empiric antifungal therapy versus standard antimicrobial therapy for non-colonic GI perforations.
- To identify predictors of organ-space surgical site infection (SSI) in this patient population.
Main Methods:
- Multi-center prospective cohort study of 192 adult patients undergoing operative management for non-colonic GI perforations.
- Propensity score matching was used to adjust for confounders.
- Subgroup analysis of spontaneous upper GI perforations was conducted.
Main Results:
- Empiric antifungal use was not associated with a reduced rate of organ-space SSI after propensity score matching (17.5% vs. 17.5%, p = 0.99).
- Higher American Society of Anesthesiologists (ASA) physical status classification system category 3 and pre-operative shock increased SSI risk.
- Perioperative proton-pump inhibitor (PPI) use demonstrated a protective effect against SSI.
Conclusions:
- Empiric antifungal therapy does not reduce organ-space SSI in patients with non-colonic GI perforations.
- Routine empiric antifungal use is not supported by current evidence and should be approached with caution.
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