Risk Factors of Ostrosky-Zeichner et al for Fluconazole Failure in a Patient with Candidemia

Ostrosky-Zeichner et al identified factors predictive of fluconazole failure in a hospitalized patient with candidemia.

Patient selection: Candidemia

Outcome: failure of fluconazole therapy

Parameters:

(1) number of days after admission before fluconazole started

(2) Candida species causing Candidemia

(3) diagnosis

(4) procedures

(5) other antifungal agents

Parameter	Finding	Odds Ratio	LN(OR) = beta coefficient
number of days		1.02	0.02
Candida species	C. glabrata	1.98	0.68
	C. krusei	8.2	2.1
	other	1	0
diagnosis	hematologic malignancy	3.25	1.18
	venous thrombo-embolism	0.51	-0.67
	other	1	0
procedure	enteral nutrition	1.56	0.44
	mechanical ventilation	1.13	0.12
	nonoperative intubation or irrigation	1.54	0.43
treatment with other antifungals	no	1	0
	yes	1.4	0.34

where:

• The model constant was not reported.

Interpretation:

• The risk of fluconazole failure is affected by the number and type of parameters present.

Performance:

• The area under the ROC curve was 0.65

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