MALE YEAST INFECTION management
of candidemia at an academic medical center Its CAUSE, TREATMENT,
SYMPTOMS, PICTURES, CURE, REMEDY, PHOTOS and PICS
Its CAUSE, TREATMENT,
SYMPTOMS, PICTURES, CURE, REMEDY, PHOTOS and PICS
|
Initial management of candidemia at an academic medical center: evaluation of the IDSA guidelines |
Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham
Treatment of candidemia is more complicated because of the changing epidemiology of Candida and introduction of newer antifungal agents. Utilization and benefit of practice guidelines and infectious disease consultation for the management of candidemia has not been previously described in the routine clinical setting. We prospectively studied the impact of the Infectious Disease Society of America (IDSA) guidelines for the management of candidemia and infectious disease consultation on clinical outcomes in 119 patients with candidemia at a tertiary care hospital. Medical records were reviewed to capture data concerning use of antifungal agents, management of central venous catheters, and infectious disease consultation. Initial antifungal therapy was consistent with the IDSA guidelines in 76% of patients. Variation from the guidelines was independently associated with higher mortality (24% versus 57%, P = 0.003). Infectious disease consultation was independently associated with lower mortality (18% versus 39%, P < 0.01). Use of the IDSA guidelines and infectious disease consultation service was found to improve patient outcomes in patients with candidemia at our institution. Further studies should be performed to validate newer guidelines in a clinical setting at other institutions.
MeSH Terms:
Academic Medical Centers*
Adult
Aged
Aged, 80 and over
Antifungal Agents/therapeutic use*
Candida/classification
Candida/drug effects
Candida/isolation & purification
Candidiasis/drug therapy
Candidiasis/microbiology
Candidiasis/mortality
Catheterization, Central Venous/adverse effects*
Disease Management*
Female
Fungemia/drug therapy*
Fungemia/microbiology
Fungemia/mortality
Humans
Male
Middle Aged
Quality of Health Care/standards
Research Support, Non-U.S. Gov't
Societies, Medical
Treatment Outcome
Substances:
Antifungal Agents