Correlation of Broad-Spectrum Antibiotic Use with Invasive Candidiasis in ICU Patients
Invasive candidiasis (IC) remains a serious infection in intensive care units, especially among patients receiving broad-spectrum antibiotics. This study examines the relationship between specific antibiotic usage patterns and IC occurrence, aiming to create a predictive model for IC in patients treated with these antibiotics.
Study Design and Methods
The research retrospectively gathered detailed data on antibiotic categories, duration of therapy, combination treatments, and other clinical factors from enrolled patients. Both univariate and multivariate logistic regression analyses identified risk factors for IC and facilitated the development of a nomogram prediction model.
Patient Cohorts and Statistical Adjustments
- 1,260 patients treated with broad-spectrum antibiotics
- 877 patients without such treatment
After adjusting for IC-related risk factors through propensity score matching (PSM) and inverse probability of treatment weighting (IPTW), broad-spectrum antibiotics consistently emerged as an independent risk factor for IC.
Key Findings on Antibiotic Classes and Therapy Duration
- Among patients on monotherapy, lipopeptides, glycopeptides, and oxazolidinones were strongly linked to a higher risk of IC.
- The longer the antibiotic treatment duration, the greater the risk of developing IC.
- Combination antibiotic therapy doubled the risk of IC, with the beta-lactams/beta-lactamase inhibitor and glycopeptide combination posing the highest 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."
Conclusion
The use of broad-spectrum antibiotics, especially certain classes and combination therapies, is strongly associated with invasive candidiasis risk in critically ill patients. Early prediction models based on these factors may improve patient management and outcomes.
Author’s summary: This study highlights the critical link between broad-spectrum antibiotic regimens and invasive candidiasis risk in ICU patients, underscoring the need for targeted early prediction models.