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Early Discontinuation of Empirical Antifungal Therapy and Biomarkers
Sponsor: University Hospital, Lille
Summary
Empirical antifungal therapy (EAT) is frequently prescribed to septic critically ill patients with risk factors for invasive Candida infections (ICI). However, among patients without subsequent proven ICI, antifungal discontinuation is rarely performed, resulting in unnecessary antifungal overuse. The investigators postulate that the use of fungal biomarkers could increase the percentage of early discontinuation of EAT among critically ill patients suspected of ICI, as compared with a standard strategy, without negative impact on day 28-mortality. To test this hypothesis, the investigators designed a randomized controlled open-label parallel-group study.
Official title: Impact of the Use of Biomarkers on Early Discontinuation of Empirical Antifungal Therapy in Critically Ill Patients: a Randomized Controlled Study.
Key Details
Gender
All
Age Range
18 Years - Any
Study Type
INTERVENTIONAL
Enrollment
194
Start Date
2018-06-06
Completion Date
2025-06
Last Updated
2024-05-16
Healthy Volunteers
No
Conditions
Interventions
Biomarker strategy
EAT duration is determined by β-D-1,3-glucan and mannan serum assays, performed at day 0 (day of EAT initiation) and day 3.
Routine strategy
EAT duration is based on IDSA guidelines, which recommend 14 days of treatment for patients without subsequent proven ICI, and who improve under antifungal treatment, or less in other situations.
Locations (10)
CH ARRAS
Arras, France
CH de DOUAI
Douai, France
CH Dunkerque
Dunkirk, France
Centre Hospitalier Dr Schaffner
Lens, France
Ch Dr.Schaffner de Lens
Lens, France
Hôpital Roger Salengro, CHU
Lille, France
CH Roubaix
Roubaix, France
CHU de Rouen
Rouen, France
Ch Tourcoing
Tourcoing, France
Centre hospitalier de valenciennes
Valenciennes, France