Antifungal use in immunocompetent, critically ill patients with pneumonia does not improve clinical outcomes Journal Article


Authors: Griffin, M.; Kosmisky, D. E.; Templin, M. A.; Huynh, T.; McCurdy, L. H. 3rd; Pasquale, T. R.; Martin, K. E.
Article Title: Antifungal use in immunocompetent, critically ill patients with pneumonia does not improve clinical outcomes
Abstract: Purpose To determine if treating bronchoalveolar lavage (BAL) culture-positive patients with antifungal therapy impacted mortality compared to not treating due to presumed colonization. Methods We conducted a retrospective study of immunocompetent, critically ill adult patients from 2010 to 2014. Patients with a BAL culture-positive for Candida or unspeciated yeast and a clinical suspicion of pneumonia were included. The treatment group received an antifungal agent for at least 5 days, and the control group received either no antifungal therapy or an antifungal agent for less than 48 h. Recruitment occurred in a 2:1 ratio of untreated versus treated patients. Results Seventy-five patients were included. In-hospital mortality was similar between treated and untreated groups (24% vs. 26%, P = 0.85). Length of stay and duration of mechanical ventilation also did not differ between the two groups. Conclusion We did not observe a difference in mortality or clinical outcomes in patients treated with antifungal agents. Presumptive antifungal therapy for BAL-positive Candida or yeast in immunocompetent patients did not result in improved clinical outcomes. © 2016 Elsevier Inc.
Keywords: pneumonia; bronchoscopy; yeast; antifungal agents; candida
Journal Title: Heart & Lung
Volume: 45
Issue: 6
ISSN: 0147-9563
Publisher: Mosby Elsevier  
Date Published: 2016-11-01
Start Page: 538
End Page: 543
Language: English
DOI: 10.1016/j.hrtlng.2016.08.002
PROVIDER: scopus
PUBMED: 27601213
DOI/URL:
Notes: Article -- Export Date: 6 December 2016 -- Source: Scopus
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  1. Meagan Griffin
    11 Griffin