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Introduction: The prompt initiation of appropriate antifungal therapy is essential in controlling invasive candidiasis and improving the prognosis in critical patients undergoing treatment in the Intensive Care Unit. Candida Score can assess patients at risk of candidiasis and is expected to assist clinicians in starting antifungal therapy in patients suspected Candidiasis. The purpose of this study was to determine the pattern of antifungal administration in critically ill patients with candidiasis in the Intensive Care Unit at Sanglah General Hospital.
Patients and Methods: The design of this study is a cross-sectional descriptive study involving critically ill patients who were under treatment in Intensive Care Unit of Sanglah General Hospital from Januari to June 2019. The patients included in this study were patients who were ≥ 18 years old and under treatment in ICU for at least 7 days.
Results: There are 64 patients undergoing treatment in the Intensive Care Unit. From 64 patients, 6 pasien had CS = 0, 29 patients had CS = 1, 13 patients had CS = 2, 11 patients had CS = 3, 5 patients had CS = 4, and no patients had CS = 5. Eleven patients received empirical antifungal therapy. All empirical antifungal therapies use the Triazole group.
Conclusion: In this study was found that 11 of 16 patients with a CS value of ≥ 2.5 were given empirical antifungal therapy, while 48 patients with a CS value of <2.5 were not given empirical antifungal therapy.
Keywords: Invasive Candidiasis, Candida Score, Empirical Antifungal Therapy.
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- Guo F, Yang Y, Kang Y, et al. Invasive candidiasis in intensive care units in China: a multicentre prospective observational study. J Antimicrob Chemother. 2013;68:1660–1668. doi:10.1093/jac/dkt083
- Guzman JA, Tchokonte R, Sobel JD. Septic Shock Due to Candidemia: Outcomes and Predictors of Shock Development. J Clin Med Res. 2011;3(2):65–71. doi:10.4021/jocmr536w
- Vincent J, Rello J, Marshall J, et al. International Study of the Prevalence and Outcomes of Infection in Intensive Care Units. JAMA. 2009;302(21):2323–2329. doi:10.1001/jama.2009.1754.
- Lortholary O, Renauat C, Sitbon K, Madec Y, Denoeud-Ndam L, Wolff M. Worrisome trends in incidence and mortality of candidemia in intensive care units. Intensive Care Med. 2014;40:1303–1312. doi:10.1007/s00134-014-3408-3
- Kett DH, Azoulay E, Echeverria PM, Vincent J. Candida bloodstream infections in intensive care units: Analysis of the extended prevalence of infection in intensive care unit study*. Crit Care Med. 2011;39(4):665–670. doi:10.1097/CCM.0b013e318206c1ca
- Bassetti M, Ansaldi F, Diaz-martin A, et al. A multicenter study of septic shock due to candidemia: outcomes and predictors of mortality. Intensive Care Med. 2014;40:839–845. doi:10.1007/s00134-014-3310-z
- Parkins MD, Sabuda DM, Elsayed S, Laupland KB. Adequacy of empirical antifungal therapy and effect on outcome among patients with invasive Candida species infections. J Antimicrob Chemother. 2007;60:613–618. doi:10.1093/jac/dkm212
- León C, Ruiz-Santana S, Saavedra P, et al. A bedside scoring system (“Candida score”) for early antifungal treatment in nonneutropenic critically ill patients with Candida colonization*. Crit Care Med. 2006;34(3):730–737. doi:10.1097/01.CCM.0000202208.37364.7D
- León C, Ruiz-santana S, Saavedra P, et al. Usefulness of the “Candida score” for discriminating between Candida colonization and invasive candidiasis in non-neutropenic critically ill patients: A prospective multicenter study. Crit Care Med. 2009;37(5):1624–1633. doi:10.1097/CCM.0b013e31819daa14
- Leroy G, Lambiotte F, Thévenin D, et al. Evaluation of “ Candida score ” in critically ill patients : a prospective , multicenter , observational , cohort study. Ann Intensive Care. 2011;1(1):50. doi:10.1186/2110-5820-1-50.
- Pappas PG, Kauffman CA, Andes DR, et al. Clinical Practice Guideline for the Management of Candidiasis: 2016 Update by the Infectious Diseases Society of America. Clin Infect Dis. 2016;62(4):1–50. doi:10.1093/cid/civ933
- Andes DR, Safdar N, Baddley JW, et al. Impact of Treatment Strategy on Outcomes in Patients with Candidemia and Other Forms of Invasive Candidiasis: A Patient-Level Quantitative Review of Randomized Trials. Clin Infect Dis. 2012;54(8):1110–1122. doi:10.1093/cid/cis021
- Reboli AC, Rotstein C, Pappas PG, et al. Anidulafungin versus Fluconazole for Invasive Candidiasis. N Engl J Med. 2007;356(24):2472–2482. doi:10.1056/NEJMoa066906