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Impact of first-line antifungal agents on the outcomes and costs of candidemia

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dc.contributor.author한상훈-
dc.date.accessioned2014-12-19T16:27:52Z-
dc.date.available2014-12-19T16:27:52Z-
dc.date.issued2012-
dc.identifier.issn0066-4804-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/89576-
dc.description.abstractCandida species are the leading causes of invasive fungal infection among hospitalized patients and are responsible for major economic burdens. The goals of this study were to estimate the costs directly associated with the treatment of candidemia and factors associated with increased costs, as well as the impact of first-line antifungal agents on the outcomes and costs. A retrospective study was conducted in a sample of 199 patients from four university-affiliated tertiary care hospitals in Korea over 1 year. Only costs attributable to the treatment of candidemia were estimated by reviewing resource utilization during treatment. Risk factors for increased costs, treatment outcome, and hospital length of stay (LOS) were analyzed. Approximately 65% of the patients were treated with fluconazole, and 28% were treated with conventional amphotericin B. The overall treatment success rate was 52.8%, and the 30-day mortality rate was 47.9%. Hematologic malignancy, need for mechanical ventilation, and treatment failure of first-line antifungal agents were independent risk factors for mortality. The mean total cost for the treatment of candidemia was $4,743 per patient. Intensive care unit stay at candidemia onset and antifungal switch to second-line agents were independent risk factors for increased costs. The LOS was also significantly longer in patients who switched antifungal agents to second-line drugs. Antifungal switch to second-line agents for any reasons was the only modifiable risk factor of increased costs and LOS. Choosing an appropriate first-line antifungal agent is crucial for better outcomes and reduced hospital costs of candidemia.-
dc.description.statementOfResponsibilityopen-
dc.relation.isPartOfANTIMICROBIAL AGENTS AND CHEMOTHERAPY-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/2.0/kr/-
dc.subject.MESHAdult-
dc.subject.MESHAged-
dc.subject.MESHAged, 80 and over-
dc.subject.MESHAmphotericin B/adverse effects-
dc.subject.MESHAmphotericin B/economics-
dc.subject.MESHAmphotericin B/therapeutic use-
dc.subject.MESHAntifungal Agents/adverse effects-
dc.subject.MESHAntifungal Agents/economics-
dc.subject.MESHAntifungal Agents/therapeutic use*-
dc.subject.MESHCandidemia/drug therapy*-
dc.subject.MESHCandidemia/economics-
dc.subject.MESHCandidemia/microbiology-
dc.subject.MESHDeoxycholic Acid/adverse effects-
dc.subject.MESHDeoxycholic Acid/economics-
dc.subject.MESHDeoxycholic Acid/therapeutic use-
dc.subject.MESHDrug Combinations-
dc.subject.MESHFemale-
dc.subject.MESHHumans-
dc.subject.MESHItraconazole/adverse effects-
dc.subject.MESHItraconazole/economics-
dc.subject.MESHItraconazole/therapeutic use-
dc.subject.MESHMale-
dc.subject.MESHMiddle Aged-
dc.subject.MESHRetrospective Studies-
dc.titleImpact of first-line antifungal agents on the outcomes and costs of candidemia-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Internal Medicine (내과학)-
dc.contributor.googleauthorYoung Eun Ha-
dc.contributor.googleauthorKyong Ran Peck-
dc.contributor.googleauthorEun-Jeong Joo-
dc.contributor.googleauthorShin Woo Kim-
dc.contributor.googleauthorSook-In Jung-
dc.contributor.googleauthorHyun Ha Chang-
dc.contributor.googleauthorKyong Hwa Park-
dc.contributor.googleauthorSang Hoon Hand-
dc.identifier.doi22526315-
dc.admin.authorfalse-
dc.admin.mappingfalse-
dc.contributor.localIdA04286-
dc.relation.journalcodeJ00189-
dc.identifier.eissn1098-6596-
dc.identifier.pmid22526315-
dc.subject.keywordAdult-
dc.subject.keywordAged-
dc.subject.keywordAged, 80 and over-
dc.subject.keywordAmphotericin B/adverse effects-
dc.subject.keywordAmphotericin B/economics-
dc.subject.keywordAmphotericin B/therapeutic use-
dc.subject.keywordAntifungal Agents/adverse effects-
dc.subject.keywordAntifungal Agents/economics-
dc.subject.keywordAntifungal Agents/therapeutic use*-
dc.subject.keywordCandidemia/drug therapy*-
dc.subject.keywordCandidemia/economics-
dc.subject.keywordCandidemia/microbiology-
dc.subject.keywordDeoxycholic Acid/adverse effects-
dc.subject.keywordDeoxycholic Acid/economics-
dc.subject.keywordDeoxycholic Acid/therapeutic use-
dc.subject.keywordDrug Combinations-
dc.subject.keywordFemale-
dc.subject.keywordHumans-
dc.subject.keywordItraconazole/adverse effects-
dc.subject.keywordItraconazole/economics-
dc.subject.keywordItraconazole/therapeutic use-
dc.subject.keywordMale-
dc.subject.keywordMiddle Aged-
dc.subject.keywordRetrospective Studies-
dc.contributor.alternativeNameHan, Sang Hoon-
dc.contributor.affiliatedAuthorHan, Sang Hoon-
dc.citation.volume56-
dc.citation.number7-
dc.citation.startPage3950-
dc.citation.endPage3956-
dc.identifier.bibliographicCitationANTIMICROBIAL AGENTS AND CHEMOTHERAPY, Vol.56(7) : 3950-3956, 2012-
dc.identifier.rimsid32325-
dc.type.rimsART-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers

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