Correlation of Broad-Spectrum Antibiotic Utilization with Invasive Candidiasis in Critically Ill Patients
Invasive candidiasis (IC) continues to be a major infection in intensive care units, marked by high incidence and mortality, especially among patients receiving broad-spectrum antibiotics.
Study Objective
The research aimed to explore how detailed patterns of antibiotic use correlate with the development of IC and to create an early predictive model tailored to patients treated with broad-spectrum antibiotics.
Methods
Researchers retrospectively gathered information on antibiotic classes, treatment durations, combination therapies, and other clinical variables from the enrolled patients. Statistical analyses, including univariate and multivariate logistic regression, were used to determine IC risk factors and to construct a nomogram-based predictive model.
Results
- A total of 1,260 patients treated with broad-spectrum antibiotics and 877 without such treatment were analyzed.
- After adjustments using propensity score matching and inverse probability of treatment weighting, broad-spectrum antibiotic use remained an independent risk factor for IC.
- Among monotherapy cases, antibiotics in the lipopeptide, glycopeptide, and oxazolidinone classes showed the strongest associations with IC occurrence.
- Longer antibiotic treatment duration was positively correlated with higher IC risk.
Combination Therapy and Risk
"Combination therapy significantly increased the risk of IC (odds ratio [OR] = 2.341, 95% confidence interval [CI]: 1.316–4.162), with the combination of beta-lactams/beta-lactamase inhibitors and glycopeptides showing the highest IC risk."
Author Summary
Broad-spectrum antibiotic use and extended or combined regimens markedly heighten the likelihood of invasive candidiasis in critically ill patients.