Utility of real-time antifungal susceptibility testing for fluconazole in the treatment of candidemia.
Our study prospectively examined the use of real-time antifungal susceptibility testing among 119 patients with candidemia at a large tertiary university medical center over a 1-year period. Susceptibility results to fluconazole were reported to physicians a mean of 5.1 days after the initial positive blood culture for Candida. Physicians believed that receiving antifungal susceptibility testing results was helpful and not infrequently altered therapy on the basis of results. Outcomes, including mortality and resolution of infection, among 20 (17%) patients with fluconazole-resistant and fluconazole-susceptible dose-dependent isolates were relatively poor compared to those among patients with fluconazole-susceptible isolates, but probably reflect severity of illness. Routine susceptibility testing as an adjunct to the treatment of candidemia has significant potential and warrants further study.
Baddley
John W
JW
Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL, USA. jbaddley@uab.edu
Patel
Mukesh
M
Jones
Marga
M
Cloud
Gretchen
G
Smith
Anita C
AC
Moser
Stephen A
SA
D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001431:Bacteriological Techniques; D002175:Candida / Q000145:classification / Q000187:drug effects*; D002177:Candidiasis / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D016009:Chi-Square Distribution; D015331:Cohort Studies; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D015725:Fluconazole / Q000008:administration & dosage / Q000494:pharmacology*; D005500:Follow-Up Studies; D016469:Fungemia / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011336:Probability; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D015996:Survival Rate; D016896:Treatment Outcome
D015725:Fluconazole