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Critical Care
Article . 2008 . Peer-reviewed
Data sources: Crossref
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Critical Care
Article
License: CC BY
Data sources: UnpayWall
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PubMed Central
Other literature type . 2008
Data sources: PubMed Central
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Antifungal prophylaxis in critically ill patients

Authors: Silvestri, Luciano; Zandstra, Durk F; van Saene, Hendrick KF; Petros, Andy J; Thyagarajan, Sujatha; de la Cal, Miguel A; Thomann, Corrado;

Antifungal prophylaxis in critically ill patients

Abstract

We congratulate van Till and colleagues on their review showing that selective decontamination of the digestive tract (SDD) is more effective than single-drug prophylaxis (SAP) in reducing yeast colonisation, infection and mortality [1]. The authors claimed that their review differs from our earlier review, which included paediatric or liver transplant patients. In our review a subgroup analysis was performed in both selected and unselected populations, and demonstrated a significant reduction in yeast carriage and infection in unselected critically ill patients [2]. van Till and colleagues assessed yeast colonisation, lumping together 'positive yeast cultures obtained from sputum, stool, urine and/or wound' [1]. The majority of SDD trials reported positive yeast cultures obtained from surveillance cultures of throat and rectal swabs, whilst the SAP studies mainly assessed positive yeast cultures obtained from diagnostic samples including lower airway secretions, urine and wound fluid. Grouping together surveillance and diagnostic cultures may be misleading in interpreting the efficacy of antifungal interventions. van Till and colleagues' review demonstrated a nonsignificant 41% reduction in candidemia by SDD and a 68% significant reduction by SAP [1]. The authors concluded that SAP prevents candidemia, whilst SDD does not. We believe that van Till and colleagues evaluated two different populations, as the candidemia rates in the control individuals were 3.79% and 1.69% for SAP and SDD, respectively. A larger sample size is almost certainly needed for SDD to demonstrate a significant reduction in candidemia [3].

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
1
Average
Average
Average
Green
gold