Echinocandins Versus Azoles for Candidemia Treatment

Completed

• Conditions: Candidemia
• Interventions: Drug: Echinocandin treatment; Drug: Triazole treatment

• Registration Number: NCT03799172
• Lead Sponsor: Hospices Civils de Lyon

Brief Summary

Candidemia is the most frequent invasive fungal disease in intensive care units (ICUs). It remains a major health concern, considering its attributable mortality up to 40% in critically ill patients. Successful clinical outcome requires early diagnosis and effective antifungal therapy. Guidelines for the treatment of candidemia were published by the Infectious Diseases Society of America (IDSA) and the European Society of Clinical Microbiology and Infectious Diseases (ESCMID). According to these guidelines, echinocandins are the preferred first-line therapy for candidemia in critically ill patients. Considering the bibliography supporting this statement, the place of triazoles still needs to be defined in candidemia therapeutic arsenal. In this context, we are setting up a retrospective cohort study using Hospital database to compare the efficacy of echinocandins and azoles for the treatment of candidemia in intensive care units.

Detailed Description

Not available

Study Timeline

• Study Start: 2018-11-01
• Study First Submitted: 2019-01-03
• Study First Submitted QC: 2019-01-07
• Study First Posted: 2019-01-10
• Primary Completion: 2019-02-01
• Study Completion: 2019-09-01
• Status Verified: 2020-03
• Last Update Submitted: 2020-03-03
• Last Update Posted: 2020-03-04

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 79

Inclusion Criteria

• Patients who had a diagnosis of candidemia during ICU stay and were treated with echinocandins or azoles

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Exclusion Criteria

• Patients with neutropenia
• Patients without antifungal treatment
• Patients who received antifungal therapy for more than two days before candidemia diagnosis
• Patients receiving liposomal amphotericin b or multiple antifungal agents as first-line therapy
• Patients who received less than 4 days of antifungal therapy after candidemia diagnosis

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Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Echinocandin group	Echinocandin treatment	Echinocandin group is the group of patients who received echinocandins as first-line therapy for candidemia
Triazole group	Triazole treatment	Triazole group is the group of patients who received triazoles as first-line therapy for candidemia

Primary Outcome Measures

Name	Time	Method
Comparison of all cause hospital mortality on day 90 between echinocandins and azoles	Mortality on day 90 after antifungal initiation	Comparison of all cause hospital mortality on day 90 between echinocandins and azoles

Secondary Outcome Measures

Name	Time	Method
Comparison of treatment success on day 30 between echinocandins and azoles.	Treatment success on day 30 after antifungal initiation	Treatment success is defined as a complete response if the following two criteria were full-filled: survival and resolution of all attributable symptoms and signs of disease, and mycological success (documented clearance of pathogen from the blood).

Trial Locations

Locations (1)

Hospices Civils de Lyon, Hôpital de la Croix-Rousse; 🇫🇷 Lyon, France