Can antibiotics affect the clinical features of patients with candidemia? The retrospective evaluation of 5 years of data in an intensive care unit

BackgroundCandidemia is an opportunistic infection of intensive care units (ICUs) and causes morbidity and mortality. Multiple antibiotic exposure was found to be an independent risk factor for mortality and non-albicans candidemia (NAC) in candidemia patients.AimThe aim of this study was to determi...

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Published in:European journal of hospital pharmacy. Science and practice 2024-09, Vol.31 (5), p.416-422
Main Authors: Durmuş, Mefküre, Kalkan, Serkan, Güzel Karahan, Sena, Biçakcioğlu, Murat, Özdemir, Nesligül, Gün, Zeynep Ülkü, Özer, Ayşe Belin
Format: Article
Language:English
Subjects:
Antibiotics
Comorbidity
critical care
Demographics
drug-related side effects and adverse reactions
epidemiology
Hemodialysis
Hospitalization
Intensive care
Length of stay
Mortality
mycology
Neutropenia
Original research
Patients
pharmacy service, hospital
Risk factors
Sepsis
Staphylococcus infections
Steroids
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Summary:BackgroundCandidemia is an opportunistic infection of intensive care units (ICUs) and causes morbidity and mortality. Multiple antibiotic exposure was found to be an independent risk factor for mortality and non-albicans candidemia (NAC) in candidemia patients.AimThe aim of this study was to determine the relationship between antibiotics and clinical features of patients with candidemia, and to determine the independent risk factors for hospital stay >50 days, 30-day mortality in hospital, candidemia types, and septic shock in candidemia patients.MethodsPatients were evaluated retrospectively for 5 years. A total of 148 candidemia cases were detected and included in the study. Characteristics of cases were defined and recorded. The relationship between qualitative data was determined by the χ2 test. Logistic regression analysis was used to determine the independent risk factors for hospital stay >50 days, 30-day mortality in hospital, candidemia types, and septic shock in candidemia patients.ResultsThe incidence of candidemia for 5 years was 4.5%. Candida parapsilosis was the most reported species with 65% (n=97). Linezolid and central venous catheters (CVC) were found to be independent risk factors for NAC. Carbapenems and cephalosporins were found in association to lower mortality. No antibiotics or characteristics were found to be independent risk factors for mortality. Some broad spectrum antibiotics and antibiotic combinations were found in relationship with hospital stay >50 days; however, none of them were found to be independent risk factors. Metisilin resistant staphylococcus aureus (MRSA) antibiotics, meropenem+linezolid piperacillin-tazobactam+fluoroquinolones and comorbidity were found in association with septic shock, although only piperacillin-tazobactam+fluoroquinolones and comorbidity were found to be independent risk factors for septic shock.ConclusionsThis study concluded that many antibiotics were safe for candidemia patients. However, clinicians should pay attention when prescribing linezolid or piperacillin-tazobactam and flouroquinolons concomitantly or sequentially for patients with candidemia risk factors.
ISSN:2047-9956
2047-9964
DOI:10.1136/ejhpharm-2022-003673