{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T13:57:42Z","timestamp":1761919062473},"reference-count":92,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2007,12,7]],"date-time":"2007-12-07T00:00:00Z","timestamp":1196985600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/2.0\/"},{"start":{"date-parts":[[2007,12,7]],"date-time":"2007-12-07T00:00:00Z","timestamp":1196985600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/2.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Crit Care"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                        <jats:title>Introduction<\/jats:title>\n                        <jats:p>The objective of this study was to determine and compare the effectiveness of different prophylactic antifungal therapies in critically ill patients on the incidence of yeast colonisation, infection, candidemia, and hospital mortality.<\/jats:p>\n                     <\/jats:sec><jats:sec>\n                        <jats:title>Methods<\/jats:title>\n                        <jats:p>A systematic review was conducted of prospective trials including adult non-neutropenic patients, comparing single-drug antifungal prophylaxis (SAP) or selective decontamination of the digestive tract (SDD) with controls and with each other.<\/jats:p>\n                     <\/jats:sec><jats:sec>\n                        <jats:title>Results<\/jats:title>\n                        <jats:p>Thirty-three studies were included (11 SAP and 22 SDD; 5,529 patients). Compared with control groups, both SAP and SDD reduced the incidence of yeast colonisation (SAP: odds ratio [OR] 0.38, 95% confidence interval [CI] 0.20 to 0.70; SDD: OR 0.12, 95% CI 0.05 to 0.29) and infection (SAP: OR 0.54, 95% CI 0.39 to 0.75; SDD: OR 0.29, 95% CI 0.18 to 0.45). Treatment effects were significantly larger in SDD trials than in SAP trials. The incidence of candidemia was reduced by SAP (OR 0.32, 95% CI 0.12 to 0.82) but not by SDD (OR 0.59, 95% CI 0.25 to 1.40). In-hospital mortality was reduced predominantly by SDD (OR 0.73, 95% CI 0.59 to 0.93, numbers needed to treat 15; SAP: OR 0.80, 95% CI 0.64 to 1.00). Effectiveness of prophylaxis reduced with an increased proportion of included surgical patients.<\/jats:p>\n                     <\/jats:sec><jats:sec>\n                        <jats:title>Conclusion<\/jats:title>\n                        <jats:p>Antifungal prophylaxis (SAP or SDD) is effective in reducing yeast colonisation and infections across a range of critically ill patients. Indirect comparisons suggest that SDD is more effective in reducing yeast-related outcomes, except for candidemia.<\/jats:p>\n                     <\/jats:sec>","DOI":"10.1186\/cc6191","type":"journal-article","created":{"date-parts":[[2007,12,7]],"date-time":"2007-12-07T19:13:31Z","timestamp":1197054811000},"update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Single-drug therapy or selective decontamination of the digestive tract as antifungal prophylaxis in critically ill patients: a systematic review"],"prefix":"10.1186","volume":"11","author":[{"given":"JW Olivier","family":"van Till","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oddeke","family":"van Ruler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bas","family":"Lamme","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roy JP","family":"Weber","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johannes B","family":"Reitsma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marja A","family":"Boermeester","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2007,12,7]]},"reference":[{"key":"5614_CR1","doi-asserted-by":"publisher","first-page":"663","DOI":"10.1007\/s100960000348","volume":"19","author":"SA Hedderwick","year":"2000","unstructured":"Hedderwick SA, Lyons MJ, Liu M, Vazquez JA, Kauffman CA: Epidemiology of yeast colonisation in the intensive care unit.\n                           Eur J Clin Microbiol Infect Dis 2000, 19: 663-670. 10.1007\/s100960000348","journal-title":"Eur J Clin Microbiol Infect Dis"},{"key":"5614_CR2","doi-asserted-by":"publisher","first-page":"867","DOI":"10.1097\/00000658-200106000-00018","volume":"233","author":"RG Sawyer","year":"2001","unstructured":"Sawyer RG, Raymond DP, Pelletier SJ, Crabtree TD, Gleason TG, Pruett TL: Implications of 2,457 consecutive surgical infections entering year 2000.\n                           Ann Surg 2001, 233: 867-874. 10.1097\/00000658-200106000-00018","journal-title":"Ann Surg"},{"key":"5614_CR3","doi-asserted-by":"publisher","first-page":"639","DOI":"10.1001\/jama.1995.03530080055041","volume":"274","author":"JL Vincent","year":"1995","unstructured":"Vincent JL, Bihari DJ, Suter PM, Bruining HA, White J, Nicolas-Chanoin MH, Wolff M, Spencer RC, Hemmer M: The prevalence of nosocomial infection in intensive care units in Europe. 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