{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T03:23:48Z","timestamp":1789874628522,"version":"4.0.1"},"reference-count":36,"publisher":"BMJ","issue":"10","license":[{"start":{"date-parts":[[2024,10,22]],"date-time":"2024-10-22T00:00:00Z","timestamp":1729555200000},"content-version":"unspecified","delay-in-days":21,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Changsha Municipal Health Commission","award":["KJ-B2023032"],"award-info":[{"award-number":["KJ-B2023032"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,9,30]]},"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      This study aimed to use systematic review and meta-analysis to establish the influence of antifungal therapy on pulmonary\n                      <jats:italic>Candida<\/jats:italic>\n                      colonisation of patients with mechanical ventilation (MV).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Systematic review and meta-analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data sources<\/jats:title>\n                    <jats:p>An extensive search was undertaken on publications from inception to 25 July 2023, through PubMed, Web of Science, Medline, Embase, China National Knowledge Infrastructure, Wanfang Data and VIP Databases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Eligibility criteria for selecting studies<\/jats:title>\n                    <jats:p>\n                      Randomised trials, cohort studies and case-control studies comparing the efficacy of antifungal treatment in immunocompetent patients with pulmonary\n                      <jats:italic>Candida<\/jats:italic>\n                      colonisation after invasive ventilation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data extraction and synthesis<\/jats:title>\n                    <jats:p>Two reviewers independently extracted the data and assessed the quality of studies. Dichotomous outcomes were expressed as ORs with 95% CIs. Continuous outcomes were expressed as standardised mean differences (SMD) with 95% CIs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>The primary outcomes included intensive care unit (ICU), hospital, 28-day, and 90-day mortality. The secondary outcomes included ICU length of stay, MV duration and ventilator-associated pneumonia (VAP).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Nine high-quality studies were included. According to the data collected from these nine studies, there is no significant evidence showing a difference between the therapy group treated with antifungal drugs and the control group without antifungal drugs in clinical outcomes, including ICU mortality (OR: 1.37; 95%\u2009CI 0.84 to 2.22), hospital mortality (OR: 1.17; 95%\u2009CI 0.57 to 2.38), 28-day mortality (OR: 0.71; 95%\u2009CI 0.45 to 1.14), 90-day mortality (OR: 0.76; 95%\u2009CI 0.35 to 1.63), ICU length of stay (SMD: \u22120.15; 95%\u2009CI \u22120.88 to 0.59), MV duration (SMD: 0.11; 95% CI \u22120.88 to 1.10) and VAP (OR: 1.54; 95%\u2009CI 0.56 to 4.20). Subgroup analysis of different treatment types indicates that the combined effect size is stable and unaffected by different treatment types including inhalation (OR: 2.32; 95%\u2009CI 0.30 to 18.09) and intravenous (OR: 0.65; 95%\u2009CI 0.13 to 3.34).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      The application of antifungal treatment did not improve clinical outcomes in patients with MV. We do not suggest initiating antifungal treatment in patients with\n                      <jats:italic>Candida<\/jats:italic>\n                      pulmonary colonisation after invasive ventilation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration number<\/jats:title>\n                    <jats:p>International Prospective Register of Systematic Reviews, CRD42020161138.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-083918","type":"journal-article","created":{"date-parts":[[2024,10,22]],"date-time":"2024-10-22T12:15:19Z","timestamp":1729599319000},"page":"e083918","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Clinical outcomes of antifungal therapy on Candida pulmonary colonisation in immunocompetent patients with invasive ventilation: a systematic review and meta-analysis"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0976-6040","authenticated-orcid":false,"given":"Linqi","family":"Li","sequence":"first","affiliation":[{"name":"The Affiliated Changsha Central Hospital, University of South China, Changsha, Hunan, China"},{"name":"School of Public Health, University of South China, Hengyang, Hunan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shan","family":"Su","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, Zhaoqing First People's Hospital, Zhaoqing, Guangdong, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongzhong","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, The Affiliated Changsha Central Hospital, University of South China, Changsha, Hunan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"He-Bin","family":"Xie","sequence":"additional","affiliation":[{"name":"The Affiliated Changsha Central Hospital, University of South China, Changsha, Hunan, China"},{"name":"School of Public Health, University of South China, Hengyang, Hunan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,10,22]]},"reference":[{"key":"2025121600222989000_14.10.e083918.1","doi-asserted-by":"crossref","DOI":"10.1093\/femspd\/ftx029","article-title":"The significance of Candida in the human respiratory tract: our evolving understanding","volume":"75","author":"Pendleton","year":"2017","journal-title":"Pathog Dis"},{"key":"2025121600222989000_14.10.e083918.2","doi-asserted-by":"crossref","first-page":"536","DOI":"10.18683\/germs.2021.1288","article-title":"Candida spp. isolation from critically ill patients\u2019 respiratory tract. 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