Background: Treatment of candidemia is complex. Studies examining relationships between patient-related factors and treatment outcome are limited, often based on all-cause mortality. Our objectives were to compare concurrent pre-specified factors between patients with and without treatment failure among adults with candidemia.
Methods: This IRB-approved, single-center case-cohort study included patients > 18 years old admitted to Duke University Hospital between June 1, 2013 and June 1, 2017 with a blood culture positive for Candida spp. Treatment-, patient-, and disease-specific data were collected, and outcome (success/failure) determined 90 days after the index culture. An odds ratio (OR) and 95% confidence interval (95% CI) were determined for receipt of renal replacement therapy (RRT), fluconazole-containing regimen, ICU stay, and neutropenia between outcome groups.
Results: Among the 112 encounters (from 110 unique patients) included, treatment success was observed in 104/112 (92.9%). Demographics were comparable between treatment success and treatment failure groups. Among patients receiving concomitant RRT,11/12 encounters (91.7%) were successfully treated. No significant differences were observed with regards to treatment failure with a fluconazole-containing regimen (OR, 1.59; 95% CI, 0.3-8.27), ICU stay (OR, 1.43; 95% CI, 0.32-6.29), and neutropenia (OR incomputable due to 0 treatment failures).
Conclusion: Treatment success occurred in 91.7% of adult patients receiving concomitant RRT while undergoing treatment for candidemia. Treatment with a fluconazole-containing regimen, RRT, ICU stay, and neutropenia did not differ between treatment outcome groups.
R. Drew, None