{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,11]],"date-time":"2025-12-11T07:34:43Z","timestamp":1765438483946,"version":"3.41.2"},"reference-count":40,"publisher":"American Society for Microbiology","issue":"5","license":[{"start":{"date-parts":[[2017,5,1]],"date-time":"2017-05-01T00:00:00Z","timestamp":1493596800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"DOI":"10.13039\/100007705","name":"Astellas | Astellas Pharma Global Development","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007705","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Antimicrob Agents Chemother"],"published-print":{"date-parts":[[2017,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            This study aimed to develop a prediction model to identify patients with candidemia who were at high risk of failing fluconazole treatment. Adult patients in the United States with candidemia who received fluconazole during hospitalization were selected from the Cerner Health Facts Hospital Database (04\/2004 to 03\/2013). Fluconazole failure was defined as switching\/adding another antifungal, positive\n            <jats:named-content content-type=\"genus-species\">Candida<\/jats:named-content>\n            culture \u226510 days after fluconazole initiation, or death during hospitalization. Patients were randomized into modeling and validation samples. Using the modeling sample, a regression analysis of least absolute shrinkage and selection operator was used to select risk predictors of fluconazole failure (demographics,\n            <jats:named-content content-type=\"genus-species\">Candida<\/jats:named-content>\n            species, initiation of fluconazole before positive culture and after admission, and comorbidities, procedures, and treatments during the 6 months before admission and fluconazole initiation). The prediction model was evaluated using the validation sample. We found that of 987 identified patients (average age of 61 years, 51% male, 72% Caucasian), 49% failed and 51% did not fail fluconazole treatment. Of those who failed, 70% switched or added another antifungal, 21% had a second positive\n            <jats:named-content content-type=\"genus-species\">Candida<\/jats:named-content>\n            test, and 42% died during hospitalization. Nine risk factors were included in the prediction model: days to start fluconazole after admission,\n            <jats:named-content content-type=\"genus-species\">Candida glabrata<\/jats:named-content>\n            or\n            <jats:named-content content-type=\"genus-species\">Candida krusei<\/jats:named-content>\n            infection, hematological malignancy, venous thromboembolism (VTE), enteral nutrition, use of nonoperative intubation\/irrigation, and other antifungal use. All but VTE were associated with a higher risk of failure. The model's c-statistic was 0.65, with a Hosmer-Lemeshow test\n            <jats:italic>P<\/jats:italic>\n            value of 0.23. In summary, this prediction model identified patients with a high risk of fluconazole failure, illustrating the potential value and feasibility of personalizing candidemia treatment.\n          <\/jats:p>","DOI":"10.1128\/aac.02091-16","type":"journal-article","created":{"date-parts":[[2017,3,7]],"date-time":"2017-03-07T01:40:36Z","timestamp":1488850836000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":11,"title":["A Risk Score for Fluconazole Failure among Patients with Candidemia"],"prefix":"10.1128","volume":"61","author":[{"given":"Luis","family":"Ostrosky-Zeichner","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, McGovern Medical School, Houston, Texas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachel","family":"Harrington","sequence":"additional","affiliation":[{"name":"Astellas Pharma US, Northbrook, Illinois, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nkechi","family":"Azie","sequence":"additional","affiliation":[{"name":"Astellas Pharma US, Northbrook, Illinois, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hongbo","family":"Yang","sequence":"additional","affiliation":[{"name":"Analysis Group, Inc., Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nanxin","family":"Li","sequence":"additional","affiliation":[{"name":"Analysis Group, Inc., Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing","family":"Zhao","sequence":"additional","affiliation":[{"name":"Analysis Group, Inc., Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valerie","family":"Koo","sequence":"additional","affiliation":[{"name":"Analysis Group, Inc., Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric Q.","family":"Wu","sequence":"additional","affiliation":[{"name":"Analysis Group, Inc., Boston, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.2165\/11315500-000000000-00000"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2007.06.008"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1306801"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2013.08.010"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1086\/496922"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/civ933"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/1469-0691.12040"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1086\/596757"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0024198"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2334-6-21"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.riam.2013.10.001"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/myc.12469"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.39.1.1"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cis697"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cit136"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0101510"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cis021"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkm212"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1086\/504810"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2007.10.001"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.3109\/13693780903208256"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1086\/599039"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.49.9.3640-3645.2005"},{"key":"e_1_3_2_25_2","volume-title":"IDWeek Final Program","author":"Kabbani S","year":"2015","unstructured":"Kabbani S SteinBHollickRLockhartSLyonGMIIIChillerTHarrisonLFarleyM. 2015. 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