OBJECTIVE: To assess the effect of aggressive antifungal prophylaxis and empiric antifungal therapy using @entity2380 on the mycotic microbiology and associated @entity166 in a surgical intensive care unit. DESIGN: Retrospective review of a cohort of critically ill surgical @entity1 treated during an 11-month period. SETTING: Surgical intensive care unit, university hospital, state-designated level I @entity130 center. @entity1 : All @entity1 treated with @entity2380 during the study. MAIN OUTCOME MEASURES: Positive fungal cultures obtained after commencement of antifungal prophylaxis or antifungal treatment with @entity2380 . Overall and infectious mortality rates for @entity1 with positive cultures were also measured. RESULTS: Of 72 surgical @entity1 who were treated with @entity2380 ; 16 (22%) had secondary mycoses. Fourteen (88%) of these @entity1 were receiving @entity2380 as antifungal prophylaxis or as empiric treatment of suspected but unproved infection. The predominant organisms isolated from these 16 @entity1 were @entity7408 (41%) and @entity7409 (41%). Overall mortality for this group was 44%, and infectious mortality was 38%. The infectious mortality rate was significantly higher than the rate found in @entity1 who were successfully treated with @entity2380 for primary mycoses, and who did not have secondary infections with resistant organisms (mortality, 9%; P < .01, chi 2). CONCLUSIONS: Emergence of resistant species after treatment with @entity2380 does occur in surgical @entity1 , and suggests that the development of a secondary @entity364 with a resistant organism may be associated with a poor prognosis.

The effect of empiric and prophylactic treatment with @entity2380 on yeast isolates in a surgical XXXX intensive care unit.

@entity1 :: ('9606', 'Species') :: ['patients', 'PATIENTS'] @entity2380 :: ('MESH:D015725', 'Chemical') :: ['fluconazole'] @entity7408 :: ('5478', 'Species') :: ['Candida glabrata'] @entity7409 :: ('5480', 'Species') :: ['Candida parapsilosis'] @entity364 :: ('MESH:D009181', 'Disease') :: ['fungal infection'] @entity166 :: ('MESH:D003141', 'Disease') :: ['infectious complications'] @entity130 :: ('MESH:D014947', 'Disease') :: ['trauma']
@entity130 :: (MESH:D014947,Disease) :: ['trauma']
