Lodise Thomas P, Garey Kevin W, Aram Jalal A, Nathanson Brian H
Department of Pharmacy Practice, Albany College of Pharmacy and Health Sciences, Albany, New York, USA.
Department of Pharmacy Practice, University of Houston College of Pharmacy, Houston, Texas, USA.
Open Forum Infect Dis. 2024 Jan 3;11(1):ofad703. doi: 10.1093/ofid/ofad703. eCollection 2024 Jan.
Scant real-world outcomes data are available among hospitalized patients with candidemia (C) or invasive candidiasis without candidemia (IC) who were treated with an echinocandin and few have assessed if there is an opportunity to accelerate the transition of their care to the outpatient setting. This study described the outcomes associated with echinocandin therapy for C/IC and determined the proportion of patients on an echinocandin at hospital discharge (HD) who were potentially eligible for an earlier HD.
A retrospective, multicenter observational study was performed using the PINC AI Healthcare Database (January 2016-April 2019) of hospitalized adult patients with C/IC who received ≥3 days of an echinocandin. Outcomes included post-index culture hospital costs and discharge location. Patients were considered potentially dischargeable earlier than actual HD day if they met the following 3 criteria prior to their actual HD day: resided on a non-intensive care unit hospital ward until HD, received any oral medications, and had no diagnostic/therapeutic interventions.
A total of 1865 patients met study criteria. Mean (standard deviation) post-index culture hospital costs for patients with C and IC were 50 196 (64 630) US dollars and 61 551 (73 080) US dollars, respectively. Of the 1008 patients on an echinocandin near HD and discharged alive, 432 (42.9%) were potentially dischargeable prior to their actual hospital day. Most patients (35.8%) were discharged to a long-term care facility.
The findings suggest that a high proportion of hospitalized C/IC patients receiving an echinocandin near the time of HD were potentially dischargeable earlier. Like all studies of this nature, the findings need to be prospectively validated.
在接受棘白菌素治疗的念珠菌血症（C）或无念珠菌血症的侵袭性念珠菌病（IC）住院患者中，可获得的真实世界结局数据很少，并且很少有研究评估是否有机会加速将其护理过渡到门诊环境。本研究描述了棘白菌素治疗C/IC的结局，并确定了出院时接受棘白菌素治疗且可能符合提前出院条件的患者比例。
使用PINC AI医疗数据库（2016年1月至2019年4月）对接受≥3天棘白菌素治疗的成年C/IC住院患者进行了一项回顾性、多中心观察性研究。结局包括索引培养后的住院费用和出院地点。如果患者在实际出院日前满足以下3条标准，则被认为比实际出院日可更早出院：直到出院一直住在非重症监护病房的医院病房、接受过任何口服药物治疗、且没有诊断/治疗干预措施。
共有1865例患者符合研究标准。C和IC患者索引培养后的平均（标准差）住院费用分别为50196（64630）美元和61551（73080）美元。在接近出院时接受棘白菌素治疗且存活出院的1008例患者中，432例（42.9%）在实际出院日前可能符合出院条件。大多数患者（35.8%）出院后前往长期护理机构。
研究结果表明，在接近出院时接受棘白菌素治疗的住院C/IC患者中，很大一部分可能可更早出院。与所有此类性质的研究一样，这些结果需要前瞻性验证。
