[Restropective investigation about the treatment of candidaemia in a French university hospital in 2004].
This study aimed to retrospectively evaluate the adequate use of antifungal drugs in the treatment of the candidaemia. A collection of clinical, biological and therapeutic data was carried out for the patients who had a positive blood culture for Candida species during the year 2004. The antifungal therapy was compared to the guidelines of the French Conference of consensus named "Prise en charge des candidoses et aspergilloses invasives de l'adulte". The degree of conformity was classified as follows: complying, partly complying (molecule in conformity but delay of treatment or unsuited dosing) and not complying with the guidelines. The analysis was performed, according to the guidelines, before and after knowledge of Candida species growing from the blood culture. On 29 candidaemia, the found species were: Candida albicans 55%, Candida glabrata 14%, Candida krusei 10%, Candida parapsilosis and Candida lusitaniae 7%, Candida pelliculosa and Candida tropicalis 3.5%. Only 19 candidaemia were included in this study because blood cultures were known positive for Candida on the day of death (N=7) or medical charts were not available (N=3). For treatment before identification of Candida species, 37% were complying, 37% in partly complying and 26% not complying with the guidelines. For the treatment after identification of the species, 26% were complying, 63% partly complying and 11% not complying with the guidelines. As a whole, antifungal therapy was totally or partly complying in 74 to 89% of candidaemia in adult patients. Lower dosages of fluconazole explained most of the treatments that partly complied with guidelines.
Herbin
G
G
Service des maladies infectieuses, CHU de Côte-de-Nacre, avenue Côte-de-Nacre, 14033 Caen cedex, France.
Goubin
P
P
Duhamel
C
C
Lebouvier
G
G
Verdon
R
R
D041221:Candida glabrata / Q000302:isolation & purification; D002177:Candidiasis / Q000188:drug therapy* / Q000191:economics / Q000453:epidemiology; D017281:Cost of Illness; D005602:France; D006785:Hospitals, University / Q000706:statistics & numerical data*; D015994:Incidence; D012008:Recurrence; D012189:Retrospective Studies