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Early Empirical Anidulafungin Reduces the Prevalence of Invasive Candidiasis in Critically Ill Patients: A Case-control Study

Md Jahidul Hasan
Md Jahidul Hasan
, 
Sharmind Neelotpol
Sharmind Neelotpol
 e 
Raihan Rabbani
Raihan Rabbani
   | 12 mag 2022
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Article Category: Research Article
Pubblicato online: 12 mag 2022
Pagine: 89 - 99
Ricevuto: 13 gen 2022
Accettato: 06 apr 2022
DOI: https://doi.org/10.2478/jccm-2022-0006
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© 2022 Md Jahidul Hasan, Sharmind Neelotpol, Raihan Rabbani, published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.

Fig. 1

ICU leaving rate within the first 10 day of ICU admission
ICU leaving rate within the first 10 day of ICU admission

Fig. 2

Kaplan-Meier survival curve for EAT group (received intravenous anidulafungin empirically) (blue line) and NEAT group (received no antifungal therapy empirically) (green line). Analysis run using groups (EAT vs. NEAT) as factor; death as event and time to death as time variable.
Kaplan-Meier survival curve for EAT group (received intravenous anidulafungin empirically) (blue line) and NEAT group (received no antifungal therapy empirically) (green line). Analysis run using groups (EAT vs. NEAT) as factor; death as event and time to death as time variable.

Demographic, information, comorbidities, laboratory test results during admission in patients received empirical anidulafungin or no empirical antifungal therapy

Characteristics Variables (N = 149) P value
EAT group (Case) (n = 77) NEAT group (Control) (n = 72)
Age (year)
Mean ± SD 60.4 ± 17.5 61.3 ± 17.6
Range (min-max) 20 - 85 22 - 90 0.762
Gender
Male 41 40
Female 36 32 0.870
Comorbidities
Diabetes, n (%) 64 (83.11) 59 (81.94) 0.001
Hypertension, n (%) 68 (88.31) 57 (79.16) 0.001
CVD, n (%) 37 (48.05) 40 (55.55) 0.842
BA, n (%) 23 (29.87) 26 (36.11) 0.577
CKD, n (%) 25 (32.46) 26 (36.11) 0.565
COPD, n (%) 14 (18.18) 12 (16.66) 0.784
CLD, n (%) 11 (14.28) 8 (11.11) 0.685
PUD, n (%) 9 (11.68) 11 (15.27) 0.723
Arthritis, n (%) 4 (5.19) 3 (4.16) 0.067
PD, n (%) 6 (7.79) 4 (5.55) 0.023
C-reactive protein (<10.0 mg/mL)
Mean ± SD 210.2 ± 112.5 221.9 ± 105
Range (min-max) 11.7 - 390.4 30.4 – 388.4 0.515
Procalcitonin (<0.1 ng/mL)
Mean ± SD 8 ± 25.9 10.8 ± 27.2
Range (min-max) 0.02 - 114 0.08 - 129 0.522
White blood cell (4-11 K/μL)
Mean ± SD 18.3 ± 4.7 18.1 ± 4.9 0.998
Range (min-max) 12.4 - 32.6 11.5 – 30.2
Serum creatinine (0.8-1.4 mg/dL)
Mean ± SD 1.7 ± 0.6 1.6 ± 0.6 0.900
Range (min-max) 0.6 - 3.3 0.7 – 2.9
SpO2 (%), Mean ± SD 92 ± 2 91 ± 3 0.586
Range (min-max) 86 - 96 87 - 98
RSO, Mean ± SD 7 ± 6 7 ± 5 0.644
Range (min-max) 2 - 14 2 - 15
Respiratory rate, (breaths/min), Mean ± SD 24 ± 3 25 ± 5 0.144
Range (min-max) 19 - 31 17 - 29
Heart rate (beat/min), Mean ± SD 98 ± 14 98 ± 9 0.062
Range (min-max) 72 - 112 72 - 109
LDH ((U/L), Mean ± SD 432 ± 189.4 467 ± 167.1
Range (min-max) 389.4 – 526.7 376.3 – 632.4 0.048
ALT (U/L), Mean ± SD 67 ± 36.6 73 ± 41.2 0.058
Range (min-max) 59.8 – 88.3 56.2 – 92.6
AST (U/L), Mean ± SD 39 ± 16.7 36 ± 19.3 0.264
Range (min-max) 32.4 – 59.7 33.7 – 72.3
APACHE II Score (0-30)
Mean ± SD 18.7 ± 4.4 17.2 ± 4.4 0.005
Range (min-max) 10 - 24 10 - 30

Incidences of invasive candidiasis and mortality rate in patients

Group IC* occurred during hospital-stay (%) P value 30-day mortality rate (n) P value
4 (5.19%)
EAT group (n = 77) Candida pneumonia 3 (3.8) Candida UTI 1 (1.2) 10.39 % (8)
1 (CA*); 2 (NAC) 1 (NAC*)
<0.001
0.040
21 (29.17%)
NEAT group (n = 72) Candida pneumonia 16 (22.2) Candida UTI 3 (4.1) Candidemia 2 (2.7) 19.44 % (14)
11 (CA); 5 (NAC) 2 (CA); 1 (NAC) 1 (CA); 1 (NAC)
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Inglese
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Medicine, Clinical Medicine, Internal Medicine, other, Surgery, Anaesthesiology, Emergency Medicine and Intensive-Care Medicine
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