Impact of Fluconazole Administration on Outcomes in Critically Ill Patients

BACKGROUNDSerious infections caused by Candida spp. are an increasingly important cause of morbidity and mortality in critically ill patients. It is unclear which patients will benefit from therapy and at what point to institute treatment.OBJECTIVETo evaluate the impact of administration of fluconazole therapy in critically ill trauma patients on mortality, length of hospital stay, incidence of deep-seated fungal infection, and positive fungal cultures from any site.METHODSWe conducted a retrospective, matched case—control study of 116 critically ill surgical trauma patients who did or did not receive fluconazole. Patients were followed until hospital discharge or death. A consecutive sample of 58 patients who received fluconazole was selected. A parallel group of patients was evaluated, from which 58 were matched with fluconazole-treated patients based on age (± 5 y), gender, and APACHE II score (± 3).RESULTSThe groups of patients were well matched, with the exception of central venous catheter placement...