{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T20:29:26Z","timestamp":1768076966364,"version":"3.49.0"},"reference-count":43,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2024,6,4]],"date-time":"2024-06-04T00:00:00Z","timestamp":1717459200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["5UM1AI069470-18"],"award-info":[{"award-number":["5UM1AI069470-18"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["UL1TR001873"],"award-info":[{"award-number":["UL1TR001873"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012264","name":"NIH","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100012264","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002387","name":"NCI","doi-asserted-by":"publisher","award":["P30CA013696"],"award-info":[{"award-number":["P30CA013696"]}],"id":[{"id":"10.13039\/501100002387","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Candidaemia is associated with poor outcomes including high mortality rates. Controversy remains regarding whether fluconazole or an echinocandin is the optimal choice for initial candidaemia treatment, particularly among high-risk patients such as the immunocompromised or critically ill.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To understand optimal initial treatment of candidaemia.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted a retrospective study of immunocompromised or ICU adult patients with candidaemia from 2010 to 2014. Patients who received \u22653 consecutive days of initial treatment with fluconazole or micafungin were included. The primary outcome was complete response at day 14, defined as clinical improvement and blood culture sterilization. Secondary outcomes included microbiological and clinical success, survival and recurrent candidaemia.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 197 patients were included; 76 received fluconazole and 121 received micafungin. There was no difference in complete response between the fluconazole and micafungin groups (ICU: 38% versus 40%, P\u200a=\u200a0.87; immunocompromised: 57% versus 59%, P\u200a=\u200a0.80). Secondary outcomes including survival were also similar. In multivariable analysis, among ICU patients, Pitt bacteraemia score\u200a&amp;lt;\u200a4 (P\u200a=\u200a0.002) and time to antifungal (P\u200a=\u200a0.037) were associated with meeting the primary outcome; white blood cell count\u200a&amp;gt;\u200a11\u2005cells\u200a\u00d7\u200a103\/\u00b5L on day 0 (P\u200a&amp;lt;\u200a0.001) and Candida isolated from a non-blood site (P\u200a=\u200a0.025) were associated with not meeting the primary outcome. Among immunocompromised patients, white blood cells\u200a&amp;gt;\u200a11\u200a\u00d7\u200a103\/\u00b5L (P\u200a=\u200a0.003) and Candida isolated from a non-blood site (P\u200a=\u200a0.026) were associated with not meeting the primary outcome.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>These data suggest that among ICU or immunocompromised patients, severity of illness rather than initial antifungal choice drove clinical outcomes.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jac\/dkae175","type":"journal-article","created":{"date-parts":[[2024,6,4]],"date-time":"2024-06-04T23:02:25Z","timestamp":1717542145000},"page":"1877-1884","source":"Crossref","is-referenced-by-count":4,"title":["Initial micafungin treatment does not improve outcomes compared to fluconazole treatment in immunocompromised and critically ill patients with candidaemia"],"prefix":"10.1093","volume":"79","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8998-113X","authenticated-orcid":false,"given":"Deborah A","family":"Theodore","sequence":"first","affiliation":[{"name":"Department of Medicine, Division of Infectious Diseases, New York-Presbyterian Hospital, Columbia University Medical Center , 622 West 168th Street, PH 8W-876, New York, NY 10032 , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amrita D","family":"Henneman","sequence":"additional","affiliation":[{"name":"Hofstra Northwell School of Nursing and Physician Assistant Studies, 160 Hofstra University , Hempstead, New York, 11549 , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Angela","family":"Loo","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, New York-Presbyterian Hospital , 630 W 168th Street, 3rd Floor, New York, NY 10032 , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9794-5665","authenticated-orcid":false,"given":"Ryan K","family":"Shields","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Pittsburgh , Falk Medical Building, Suite 3A, 3601 Fifth Avenue, Pittsburgh, PA 15213 , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory","family":"Eschenauer","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Michigan Medicine, College of Pharmacy , 428 Church Street, Ann Arbor, MI 48109-1065 , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Magdalena E","family":"Sobieszczyk","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Infectious Diseases, New York-Presbyterian Hospital, Columbia University Medical Center , 622 West 168th Street, PH 8W-876, New York, NY 10032 , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9819-440X","authenticated-orcid":false,"given":"Christine J","family":"Kubin","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Infectious Diseases, New York-Presbyterian Hospital, Columbia University Medical Center , 622 West 168th Street, PH 8W-876, New York, NY 10032 , USA"},{"name":"Department of Pharmacy, New York-Presbyterian Hospital , 630 W 168th Street, 3rd Floor, New York, NY 10032 , USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,6,4]]},"reference":[{"key":"2024073123520146100_dkae175-B1","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1086\/421946","article-title":"Nosocomial bloodstream infections in US hospitals: analysis of 24,179 cases from a prospective nationwide surveillance study","volume":"39","author":"Wisplinghoff","year":"2004","journal-title":"Clin 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