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Can antibiotics affect the clinical features of patients with candidemia? The retrospective evaluation of 5 years of data in an intensive care unit
  1. Mefküre Durmuş1,
  2. Serkan Kalkan2,
  3. Sena Güzel Karahan1,
  4. Murat Biçakcioğlu2,
  5. Nesligül Özdemir3,
  6. Zeynep Ülkü Gün1,
  7. Ayşe Belin Özer2
  1. 1 Clinical Pharmacy, İnönü University Faculty of Pharmacy, Malatya, Turkey
  2. 2 Anesthesiology and Reanimation, İnönü University Faculty of Medicine, Malatya, Turkey
  3. 3 Clinical Pharmacy, Hacettepe University, Ankara, Turkey
  1. Correspondence to Mrs Sena Güzel Karahan; ssenagzll{at}gmail.com

Abstract

Background Candidemia 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.

Aim The 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.

Methods Patients 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.

Results The 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.

Conclusions This 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.

  • epidemiology
  • critical care
  • pharmacy service, hospital
  • mycology
  • drug-related side effects and adverse reactions

Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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Data availability statement

All data relevant to the study are included in the article or uploaded as supplementary information.

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