Intravascular Catheter Exchange and Duration of Candidemia
Abstract
During a comparative trial of amphotericin B vs. fluconazole for treatment of candidemia in nonneutropenic patients, data on the management of intravascular catheters were collected. Complete records were available for 91% of the 206 study patients. For the subset of patients with a catheter in place at the time of their first positive blood culture, removal and replacement of all intravascular catheters without exchange over a guidewire from a preexisting line on or before the first day the study drug was administered were associated with a reduction in the subsequent mean duration (+/- SE) of candidemia, from 5.6 +/ -0.8 days to 2.6 +/- 0.5 days (P < .001).
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Venous catheter infection and IC guidelines, including the current IDSA guidelines, recommend removal of any intravascular catheter that is positive for a fungal pathogen (i.e., Candida) based on evidence from large retrospective and observational studies.
“Venous catheter infection and IC guidelines, including the current IDSA guidelines, recommend removal of any intravascular catheter that is positive for a fungal pathogen (ie, Candida) based on evidence from large retrospective and observational studies.”
From Fungal Sepsis: Optimizing Antifungal Therapy in the Critical Care Setting (2011) · cites this paper as [176]
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- Authors
- Rex, J. H., Bennett, J. E., Sugar, A. M., Pappas, P. G., Serody, J., Edwards, J. E., Washburn, R. G., NIAID Mycoses Study Group, & Candidemia Study Group
- Venue
- Clinical Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 1995-10-01
- Volume
- 21
- Issue
- 4
- Pages
- 994-996
- ISSN
- 1058-4838 (ISSN-L)
- 1537-6591
- OpenAlex
- W2163752788
- Cited by
- 252
- References
- 7
- Citations by year
- 2025: 1 · 2024: 1 · 2022: 1 · 2021: 5 · 2020: 3 · 2019: 4 · 2018: 2 · 2017: 8 · 2016: 4 · 2015: 7 · 2014: 14 · 2013: 14 · 2012: 18
- FWCI
- 5.46
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Infectious Diseases (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (n01ai015082-002)
- National Institute of Allergy and Infectious Diseases (N01 AI15082)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
- Health Sciences › Health Professions › Emergency Medical Services › Central Venous Catheters and Hemodialysis
- Health Sciences › Medicine › Epidemiology › Infective Endocarditis Diagnosis and Management
- Keywords
- candidemia, catheter removal, amphotericin B, fluconazole, non-neutropenic patients, antifungal therapy, catheter-related infection
- MeSH terms
- Amphotericin B, Antifungal Agents, Candidiasis, Catheterization, Humans, Time Factors, Fluconazole
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