(1,3)-β-d-Glucan-based antifungal treatment in critically ill adults at high risk of candidaemia: an observational study

• DOI: 10.1093/jac/dkw112
• Publication Date: 2016-04-28T22:45:41Z
• Authors: Brunella Posteraro; Mario Tumbarello; Gennaro De Pascale; Elvira Liberto; Maria S. Vallecoccia; Elena De Carolis; Valentina Di Gravio; Enrico M. Trecarichi; Maurizio Sanguinetti; Massimo Antonelli
• Keywords: Echinocandins; Invasive candidiasis; Antifungal drugs

To determine the effects of a strategy that uses serum (1,3)-β-d-glucan (BDG) results for antifungal treatment ICU patients at high risk invasive candidiasis. Adult admitted to from January 2012 June 2014 were included if they exhibited sepsis time BDG testing and met Candida score components ≥3. A retrospective analysis collected data was performed. In total, 198 studied. Of 63 BDG-positive patients, 47 with candidaemia 16 probable infection, all [31.8% (63/198)] received therapy. 135 BDG-negative 110 [55.5% (110/198)] did not receive therapy, whereas 25 [12.6% (25/198)] initially treated. Overall, therapy started in 88 cases (44.4%), mostly echinocandins. Antifungals discontinued 14 as negative became available, BDG-false-positive whom subsequent findings allowed (and other forms candidiasis) be ruled out. Candidaemia diagnosed only one patient who prior The median duration candidaemic differed significantly non-candidaemic [14 (IQR, 6–18) days versus 4 3–7) days; P < 0.001]. Using this approach, avoided ∼73% potentially treatable it shortened another ∼20%. This study supports use management systemic drug prescription septic patients. These need confirmed additional studies.