Candidemia Treatment is Improved by Infectious Disease Consultation: A Population-Based Cohort Study

Area of Science:

• Infectious Diseases
• Internal Medicine
• Public Health

Background:

• Candidemia is a serious bloodstream infection with significant morbidity and mortality.
• Established guidelines exist for managing candidemia, but adherence and the impact of specialist consultation require further clarification.

Purpose of the Study:

• To evaluate the role of infectious diseases consultation (IDC) in achieving evidence-based recommendations for adult candidemia patients.
• To assess the association between IDC and adherence to best practices in candidemia management.
• To determine the impact of IDC on patient outcomes, including mortality.

Main Methods:

• Multicentre retrospective cohort study conducted in Canada from 2010 to 2018.
• Inclusion of adult patients diagnosed with candidemia.
• Analysis of associations between IDC and adherence to recommendations such as follow-up blood cultures, prompt antifungal therapy, source control, and appropriate treatment duration.

Main Results:

• Patients receiving IDC were less likely to be without antifungal therapy (4.8% vs 26%).
• Appropriate treatment duration for complicated candidemia was higher with IDC (100% vs 47%).
• Mortality rates at 30 and 60 days were significantly lower in patients who received IDC (P < 0.05).

Conclusions:

• Infectious diseases physician involvement in candidemia management enhances adherence to best practice guidelines.
• IDC is associated with a considerable decrease in mortality for patients with candidemia.
• While adherence to all guidelines varied, specialist consultation plays a crucial role in improving care and outcomes.