373. Impact of Concurrent Renal Replacement Therapy on Treatment Outcomes of Candidemia in Adults
Session: Poster Abstract Session: Fungal Disease: Management and Outcomes
Thursday, October 4, 2018
Room: S Poster Hall
Posters
  • CandidemiaRRT_IDWeek_9.20.pdf (273.7 kB)
  • 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.

    Brandon Hill, PharmD, BCPS1,2, Dustin Wilson, PharmD, BCPS1,2 and Richard Drew, PharmD, MS, FCCP, FIDP1,2, (1)Duke University Hospital, Durham, NC, (2)Campbell University College of Pharmacy & Health Sciences, Buies Creek, NC

    Disclosures:

    B. Hill, None

    D. Wilson, None

    R. Drew, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 3rd with the exception of research findings presented at the IDWeek press conferences.