A retrospective Evaluation of fluconazole for the treatment of Candida glabrata fungemia.

摘要: Abstract Background: Candida glabrata accounts for 21% of bloodstream isolates in the United States and ranges from susceptible-dose-dependent to resistant fluconazole. A fluconazole dose 800 mg/d (∼12 mg/kg per day) is predicted produce peak plasma concentrations that surpass MIC breakpoint 16 32 μg/mL. Accordingly, Infectious Diseases Society America treatment guidelines candidiasis recommend 12 day as an alternative option C fungemia. Objective: The main objective this study was evaluate retrospectively a Methods: Data were collected through database stores patient information electronically can be accessed queried, chart review at Barnes-Jewish Hospital (St. Louis, Missouri) January 1999 August 2002. Eligible patients who had least 1 positive blood culture received identified electronic query. Chart reviews these followed. primary outcomes fungemia eradication in-hospital mortality. Results: Of total 124 cases identified, 54 charts evaluable. revealed 65% (17/26) receiving sole antifungal therapy successful , whereas ∼54% (15/28) changed amphotericin B formulation eradication. Although no association found between entire population, higher doses (≥400 mg/d) more likely achieve than lower (≤400 subset only ( P = 0.042). Mortality rates ∼24% (4/17) 40% (6/15) having with alone followed by B, respectively, compared 38% (3/8) persistent alone. Conclusions: Fluconazole viable fungemia, mortality 24% retrospective review.