{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:28:41Z","timestamp":1787099321347,"version":"build-2736575974"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T00:00:00Z","timestamp":1781136000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T00:00:00Z","timestamp":1787097600000},"content-version":"vor","delay-in-days":69,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Pharm Health Care Sci"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Candidemia has high mortality and requires early antifungal stewardship (AFS). Management by non-infectious disease specialists has been associated with worse outcomes, particularly in small- and medium-sized hospitals where infectious disease expertise is often limited. Rapid diagnostic tools such as polymerase chain reaction (PCR) may facilitate earlier stewardship support; however, their clinical impact in these settings remains unclear. This study aimed to evaluate the effect of PCR-based AFS on candidemia management in small- and medium-sized hospitals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We compared clinical data before and after the implementation of a PCR-based assay in patients aged\u2009\u2265\u200918 years with\n                      <jats:italic>Candida<\/jats:italic>\n                      species detected in blood cultures at Sapporo Tokushukai Hospital between June 2018 and May 2024 (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200971 after exclusion). The primary endpoint was 30-day mortality rate. We also assessed the following secondary endpoints: rate of appropriate initial antifungal therapy, removal of central venous catheters (CVCs) within 24\u00a0h of diagnosis, prolonged antifungal therapy for \u2265\u200914 d after blood culture clearance, and time to antifungal therapy initiation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      No significant difference in 30-day mortality rate was observed between the pre-PCR and post-PCR groups (36.1% vs. 34.3%). Similarly, no significant differences were observed in rate of appropriate initial antifungal therapy, removal of CVCs within 24\u00a0h of diagnosis, prolonged antifungal therapy for \u2265\u200914 d after blood culture clearance, or time to therapy initiation. However, the proportion of physicians less familiar with candidemia care was significantly higher in the post-PCR group than in the pre-PCR group (68.6% vs. 36.1%,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>PCR-based AFS might have allowed the quality of candidemia management and patient outcomes to be maintained, even in small- and medium-sized hospitals with a high proportion of physicians less familiar with candidemia care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s40780-026-00596-w","type":"journal-article","created":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T14:45:40Z","timestamp":1781189140000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of polymerase chain reaction-based antifungal stewardship on candidemia management in small- and medium-sized hospitals"],"prefix":"10.1186","volume":"12","author":[{"given":"Koji","family":"Miyazaki","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoyuki","family":"Ishigo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miyu","family":"Yamada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryoma","family":"Takeda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoki","family":"Wada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Itaya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masaji","family":"Saijo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takanobu","family":"Hoshi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshitaka","family":"Saito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,6,11]]},"reference":[{"key":"596_CR1","doi-asserted-by":"publisher","first-page":"1200","DOI":"10.1016\/j.cmi.2019.04.024","volume":"25","author":"P Koehler","year":"2019","unstructured":"Koehler P, Stecher M, Cornely OA, Koehler D, Vehreschild MJGT, Bohlius J, et al. 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(Tokyo, Japan) (Ethical Review Number: TGE 02452-010, approved on April 18, 2024). Informed consent was obtained in the form of opt-out.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"74"}}