{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T04:33:16Z","timestamp":1790742796807,"version":"4.1.0"},"reference-count":23,"publisher":"American Society for Microbiology","issue":"6","license":[{"start":{"date-parts":[[2012,6,1]],"date-time":"2012-06-01T00:00:00Z","timestamp":1338508800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Antimicrob Agents Chemother"],"published-print":{"date-parts":[[2012,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            Prior use of fluconazole is a modifiable risk factor for the isolation of fluconazole-nonsusceptible\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">Candida<\/jats:named-content>\n            species. Optimization of the use of fluconazole by appropriate dose or duration may be able to minimize the risk of resistance. The objective of this study was to evaluate the effects of prior fluconazole therapy, including the dose and duration, on fluconazole susceptibility among\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">Candida<\/jats:named-content>\n            species isolated from hospitalized patients with candidemia. A retrospective cohort study of hospitalized patients with a first occurrence of nosocomial candidemia, from 2006 to 2009, was carried out. The relationships between the initial dose and duration of prior fluconazole therapy and the isolation of fluconazole-nonsusceptible\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">Candida<\/jats:named-content>\n            species were assessed. An initial fluconazole dose greater than 2 mg\/kg and less than 6 mg\/kg of body weight was considered suboptimal. A total of 177 patients were identified, of whom 133 patients aged 61 \u00b1 16 years (56% male, 51% Caucasian, 51% with an APACHE II score of \u226515) had candidemia more than 2 days after the hospital admission day. Nine of 107 (8%) patients with fluconazole-susceptible\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">Candida<\/jats:named-content>\n            species and 9 of 26 (35%) patients with fluconazole-nonsusceptible\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">Candida<\/jats:named-content>\n            species had prior fluconazole exposure (risk ratio [RR], 3.03; 95% confidence interval [95% CI], 1.57 to 5.86;\n            <jats:italic>P<\/jats:italic>\n            , 0.0022). Preexposure with an initial dose of fluconazole greater than 2 mg\/kg and less than 6 mg\/kg occurred in 3 of 9 (33%) and 8 of 9 (89%) patients with fluconazole-susceptible and fluconazole-nonsusceptible\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">Candida<\/jats:named-content>\n            species, respectively (\n            <jats:italic>P<\/jats:italic>\n            , 0.0498). We conclude that patients with candidemia due to fluconazole-nonsusceptible\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">Candida<\/jats:named-content>\n            species were more likely to have received prior fluconazole therapy. Suboptimal initial dosing of prior fluconazole therapy was associated with candidemia with fluconazole-nonsusceptible\n            <jats:named-content xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" content-type=\"genus-species\" xlink:type=\"simple\">Candida<\/jats:named-content>\n            species.\n          <\/jats:p>","DOI":"10.1128\/aac.00019-12","type":"journal-article","created":{"date-parts":[[2012,3,13]],"date-time":"2012-03-13T04:50:36Z","timestamp":1331614236000},"page":"3239-3243","update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":52,"title":["Impact of Prior Inappropriate Fluconazole Dosing on Isolation of Fluconazole-Nonsusceptible Candida Species in Hospitalized Patients with Candidemia"],"prefix":"10.1128","volume":"56","author":[{"given":"Dhara N.","family":"Shah","sequence":"first","affiliation":[{"name":"University of Houston College of Pharmacy, Houston"},{"name":"St. Luke's Episcopal Hospital, Houston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymond","family":"Yau","sequence":"additional","affiliation":[{"name":"St. Luke's Episcopal Hospital, Houston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Todd M.","family":"Lasco","sequence":"additional","affiliation":[{"name":"St. Luke's Episcopal Hospital, Houston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaye","family":"Weston","sequence":"additional","affiliation":[{"name":"Baptist Health System, San Antonio, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel","family":"Salazar","sequence":"additional","affiliation":[{"name":"St. Luke's Episcopal Hospital, Houston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah R.","family":"Palmer","sequence":"additional","affiliation":[{"name":"St. Luke's Episcopal Hospital, Houston"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin W.","family":"Garey","sequence":"additional","affiliation":[{"name":"University of Houston College of Pharmacy, Houston"},{"name":"St. Luke's Episcopal Hospital, Houston"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01053-05"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01305-05"},{"key":"e_1_3_2_4_2","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1097\/01.md.0000091182.93122.8e","article-title":"Candidemia in a tertiary care cancer center: in vitro susceptibility and its association with outcome of initial antifungal therapy","volume":"82","author":"Antoniadou A","year":"2003","unstructured":"AntoniadouA. 2003. Candidemia in a tertiary care cancer center: in vitro susceptibility and its association with outcome of initial antifungal therapy. Medicine (Baltimore) 82:309\u2013321.","journal-title":"Medicine (Baltimore)"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1086\/529435"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.49.8.3171-3177.2005"},{"key":"e_1_3_2_7_2","doi-asserted-by":"crossref","first-page":"919","DOI":"10.1002\/pds.1365","article-title":"Inadequacy of fluconazole dosing in patients with candidemia based on Infectious Diseases Society of America (IDSA) guidelines","volume":"16","author":"Garey KW","year":"2007","unstructured":"GareyKW. 2007. Inadequacy of fluconazole dosing in patients with candidemia based on Infectious Diseases Society of America (IDSA) guidelines. Pharmacoepidemiol. Drug Saf. 16:919\u2013927.","journal-title":"Pharmacoepidemiol. Drug Saf."},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.00479-10"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/0163-4453(93)92761-K"},{"key":"e_1_3_2_10_2","first-page":"2312","article-title":"A randomized controlled trial of an enhanced patient compliance program for Helicobacter pylori therapy","volume":"159","author":"Lee M","year":"1999","unstructured":"LeeM. 1999. A randomized controlled trial of an enhanced patient compliance program for Helicobacter pylori therapy. Arch. Intern. Med. 159:2312\u20132316.","journal-title":"Arch. Intern. 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Candidemia in nonneutropenic critically ill patients: risk factors for non-albicans Candida spp. Crit. Care Med. 36:2034\u20132039.","journal-title":"Crit. Care Med."},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-0691.2010.03208.x"},{"key":"e_1_3_2_20_2","doi-asserted-by":"crossref","first-page":"2146","DOI":"10.1093\/jac\/dkr244","article-title":"Evaluation of antifungal therapy in patients with candidaemia based on susceptibility testing results: implications for antimicrobial stewardship programmes","volume":"66","author":"Shah DN","year":"2011","unstructured":"ShahDN. 2011. Evaluation of antifungal therapy in patients with candidaemia based on susceptibility testing results: implications for antimicrobial stewardship programmes. J. Antimicrob. Chemother. 66:2146\u20132151.","journal-title":"J. Antimicrob. 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