NDLI: Oral nystatin prophylaxis in surgical/trauma ICU patients: a randomised clinical trial

Content Provider	Springer Nature : BioMed Central
Author	Giglio, Mariateresa Caggiano, Giuseppina Dalfino, Lidia Brienza, Nicola Alicino, Ilaria Sgobio, Aurelia Favale, Antonella Coretti, Caterina Montagna, Maria Teresa Bruno, Francesco Puntillo, Filomena
Abstract	Introduction Candida prophylaxis in ICU is still a matter of debate. Oral chemoprophylaxis has been advocated to reduce the incidence of Candida colonisation and infection. Methods We performed a randomised trial studying a single drug (nystatin) versus control in surgical/trauma ICU patients. Multiple-site testing for fungi was performed in each patient on ICU admission (T0) and subsequently every 3 days (T3, T6, T9, and so forth). The primary evaluation criterion was the time course of the corrected colonisation index. Results Ninety-nine patients were enrolled. At admission, 69 patients exhibited Candida colonisation: the most frequently colonised body sites were the stomach and the pharynx. The most frequent isolated species was Candida albicans. The corrected colonisation index was similar in the two groups at T0 (P = 0.36), while a significant statistical difference was observed between the treatment and control groups at T6 (median 0.14 and 0.33, respectively; P = 0.0016), at T9 (median 0.00 and 0.28, respectively; P = 0.0001), at T12 (median 0.00 and 0.41, respectively; P = 0.0008), and at T15 (median 0.00 and 0.42, respectively; P < 0.0003). The same results were obtained in the subgroup of patients already colonised at ICU admission. Conclusion This trial shows that nystatin prophylaxis significantly reduces fungal colonisation in surgical/trauma ICU patients, even if already colonised. Trial registration ClinicalTrials.gov: NCT01495039
Related Links	https://ccforum.biomedcentral.com/counter/pdf/10.1186/cc11300.pdf
Ending Page	9
Page Count	9
Starting Page	1
File Format	HTM / HTML
ISSN	13648535
DOI	10.1186/cc11300
Journal	Critical Care
Issue Number	2
Volume Number	16
Language	English
Publisher	BioMed Central
Publisher Date	2012-04-10
Access Restriction	Open
Subject Keyword	Intensive Critical Care Medicine Emergency Medicine Candida Species Nystatin Sequential Organ Failure Assessment Score Invasive Candidiasis Fungal Colonisation
Content Type	Text
Resource Type	Article
Subject	Critical Care and Intensive Care Medicine
Journal Impact Factor	8.8/2023
5-Year Journal Impact Factor	10.4/2023

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