Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Sep;66(9):810-814.
doi: 10.1111/myc.13621. Epub 2023 Jun 1.

Effect of the implementation of clinical guidelines on management of candidemia in elderly patients

Natalia Vicente Lopez  1   2 , Jorge Calderon Parra  1 , Alejandro Muñoz Serrano  1 , Andrea Gutiérrez Villanueva  1 , Sara de la Fuente Moral  1 , Victor Moreno-Torres  1   3 , Elena Muñez Rubio  1 , Antonio Ramos Martínez  1   2
Affiliations

Effect of the implementation of clinical guidelines on management of candidemia in elderly patients

Natalia Vicente Lopez et al. Mycoses. 2023 Sep.

Abstract

Introduction: Mortality from candidemia is higher in elderly population than in younger patients, which may be related to suboptimal management. The aim of the present study is to evaluate adherence to the recommendations for the clinical management of candidemia in a population over 75 years before and after implementing specific training.

Patients and methods: We recorded retrospectively data from candidemia episodes in elderly patients during two periods of time: 2010-2015 years (before training) and 2017-2022 years (after training), as well as adherence to the recommendations of the clinical practice guidelines, mortality and consultation to infectious disease specialists.

Results: Forty-five episodes of candidemia were recorded in the first period and 29 episodes in the second period. A better compliance to the recommendations of the clinical practice guidelines was observed in the second period: echocardiogram performance (75.9% vs. 48.9% p = .021), fundoscopy (65.5% vs. 44.4% p = .076), follow-up blood cultures (72.4% vs. 42.2% p = .011), removal of central venous catheter (80% vs. 52.9% p = .080) and adequate antifungal treatment (82.6% vs. 52.6% p = .018). A trend towards lower mortality was observed during the second period (27.6% vs. 44.4% p = .144).

Conclusion: The improvement of knowledge of clinical guidelines on candidemia and the participation of infectious disease specialists may increase the quality of care in elderly patients with candidemia. It would be necessary to enlarge the sample size to evaluate the real impact of this intervention on mortality.

Keywords: Candida; candidaemia; candidemia.

PubMed Disclaimer

References

REFERENCES

    1. European centre for disease prevention and control. Point prevalence survey of healthcare-associated infections and antimicrobial use in European acute care hospitals 2011-2012. 2012.
    1. Wey SB, Mori M, Pfaller MA, Woolson RF, Wenzel RP. Hospital-acquired candidemia. The attributable mortality and excess length of stay. Arch Intern Med. 1988;148(12):2642-2645.
    1. Fraser VJ, Jones M, Dunkel J, Storfer S, Medoff G, Dunagan WC. Candidemia in a tertiary care hospital: epidemiology, risk factors, and predictors of mortality. Clin Infect Dis. 1992;15(3):414-421.
    1. Andes DR, Safdar N, Baddley JW, et al. Impact of treatment strategy on outcomes in patients with candidemia and other forms of invasive candidiasis: a patient-level quantitative review of randomized trials. Clin Infect Dis. 2012;54(8):1110-1122.
    1. Ouchi Y, Rakugi H, Arai H, et al. Redefining the elderly as aged 75 years and older: proposal from the joint Committee of Japan Gerontological Society and the Japan geriatrics society. Geriatr Gerontol Int. 2017;17(7):1045-1047.

Substances

LinkOut - more resources