{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T08:10:47Z","timestamp":1785312647202,"version":"3.55.0"},"reference-count":27,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2023,6,1]],"date-time":"2023-06-01T00:00:00Z","timestamp":1685577600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Mycoses"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Mortality from candidemia is higher in elderly population than in younger patients, which may be related to suboptimal management. The aim of the present study is to evaluate adherence to the recommendations for the clinical management of candidemia in a population over 75\u2009years before and after implementing specific training.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Methods<\/jats:title><jats:p>We recorded retrospectively data from candidemia episodes in elderly patients during two periods of time: 2010\u20132015\u2009years (before training) and 2017\u20132022\u2009years (after training), as well as adherence to the recommendations of the clinical practice guidelines, mortality and consultation to infectious disease specialists.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty\u2010five episodes of candidemia were recorded in the first period and 29 episodes in the second period. A better compliance to the recommendations of the clinical practice guidelines was observed in the second period: echocardiogram performance (75.9% vs. 48.9% <jats:italic>p<\/jats:italic>\u2009=\u2009.021), fundoscopy (65.5% vs. 44.4% <jats:italic>p<\/jats:italic>\u2009=\u2009.076), follow\u2010up blood cultures (72.4% vs. 42.2% <jats:italic>p<\/jats:italic>\u2009=\u2009.011), removal of central venous catheter (80% vs. 52.9% <jats:italic>p<\/jats:italic>\u2009=\u2009.080) and adequate antifungal treatment (82.6% vs. 52.6% <jats:italic>p<\/jats:italic>\u2009=\u2009.018). A trend towards lower mortality was observed during the second period (27.6% vs. 44.4% <jats:italic>p<\/jats:italic>\u2009=\u2009.144).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The improvement of knowledge of clinical guidelines on candidemia and the participation of infectious disease specialists may increase the quality of care in elderly patients with candidemia. It would be necessary to enlarge the sample size to evaluate the real impact of this intervention on mortality.<\/jats:p><\/jats:sec>","DOI":"10.1111\/myc.13621","type":"journal-article","created":{"date-parts":[[2023,6,2]],"date-time":"2023-06-02T06:10:43Z","timestamp":1685686243000},"page":"810-814","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Effect of the implementation of clinical guidelines on management of candidemia in elderly patients"],"prefix":"10.1111","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9620-2667","authenticated-orcid":false,"given":"Natalia Vicente","family":"Lopez","sequence":"first","affiliation":[{"name":"Internal Medicine Hospital Universitario Puerta de Hierro Majadahonda  Madrid Spain"},{"name":"Universidad Aut\u00f3noma de Madrid  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorge Calderon","family":"Parra","sequence":"additional","affiliation":[{"name":"Internal Medicine Hospital Universitario Puerta de Hierro Majadahonda  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro Mu\u00f1oz","family":"Serrano","sequence":"additional","affiliation":[{"name":"Internal Medicine Hospital Universitario Puerta de Hierro Majadahonda  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea Guti\u00e9rrez","family":"Villanueva","sequence":"additional","affiliation":[{"name":"Internal Medicine Hospital Universitario Puerta de Hierro Majadahonda  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"de la Fuente\u00a0Moral","sequence":"additional","affiliation":[{"name":"Internal Medicine Hospital Universitario Puerta de Hierro Majadahonda  Madrid 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