Impact of the Disk Diffusion Test on Fluconazole De-Escalation in Patients with Candidemia
Issued Date
2022-11-01
Resource Type
eISSN
2309608X
Scopus ID
2-s2.0-85141886671
Journal Title
Journal of Fungi
Volume
8
Issue
11
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of Fungi Vol.8 No.11 (2022)
Suggested Citation
Tantasuwan S., Chongtrakool P., Waesamaae A., Chayakulkeeree M. Impact of the Disk Diffusion Test on Fluconazole De-Escalation in Patients with Candidemia. Journal of Fungi Vol.8 No.11 (2022). doi:10.3390/jof8111185 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/83097
Title
Impact of the Disk Diffusion Test on Fluconazole De-Escalation in Patients with Candidemia
Author's Affiliation
Other Contributor(s)
Abstract
Disk diffusion (DD) is a simple antifungal susceptibility method for Candida. This study examined the impact of fluconazole DD testing on antifungal de-escalation. We enrolled patients with candidemia whose Candida isolates were tested for fluconazole susceptibility using DD between January 2019 and January 2020. The historical controls were patients with candidemia who underwent fluconazole susceptibility testing using the broth microdilution (BMD) method. Clinical data including antifungal therapy were analyzed. In total, 108 patients were enrolled. Most baseline characteristics were comparable between the groups. C. tropicalis was the predominant isolate (54.6%), followed by C. albicans (17.6%). The rates of antifungal de-escalation within 72 h were 25.9 and 9.3% in the DD and BMD groups, respectively (p = 0.023). The median time to de-escalation was 3 days in the DD group, versus 6 days in the BMD group (p = 0.037). The 14-day mortality rate and antifungal cost tended to be lower in the DD group. There were no differences in the length of hospital stay and treatment-related complications between the two groups. The agreement between the DD and BMD results was 90%. DD testing can be substituted for BMD to enhance antifungal de-escalation and antifungal stewardship.