852. Candidemic Patient with CVC - No Need
Session: Symposium: Great Debates in Mycology
Saturday, October 22, 2011: 10:30 AM
Room: 205ABC
Current guidelines for the management of candidemia strongly recommend prompt removal of all central venous catheters (CVCs) in non-neutropenic patients with candidemia. These recommendations are based on studies that showed better outcomes in patients who had the CVC removed. However, these studies suffer from serious flaws, strongly limiting the strength of these recommendations.  This presentation discusses the results of a recently published sub-analysis of two large randomized clinical trials of treatment of candidemia. By showing that early (within 24 or 48 hours from treatment initiation) CVC removal did not influence any of 6 important outcomes (success, death at 28 and 42 days, rates or persistent and recurrent candidemia, and time to mycological eradication), the results of this study indicate the need of a revision in the guideline recommendations.


Marcio Nucci, MD, Department of Internal Medicine, Federal University of Rio de Janeiro, Rio de Janeiro - RJ , Brazil

Associate Professor, Department of Internal Medicine, Head, Mycology Laboratory, University Hospital, Federal University of Rio de Janeiro. Cordinator of the Supportive Care Program of the Hematology and Bone Marrow Transplant Unit. Main fields of interest: infections in compromised hosts, especially neutrpenic patients and hematopoietic stem cell transplant recipients; invasive mycosis.



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