The Self-Defense Skill Linked To NLG919

In 2007, fluconazole was added to the prophylactic antibiotic treatment for patients with gastrointestinal tract perforations or reoperation after colorectal surgery in two university hospitals in Copenhagen. Changes in candidaemia rates associated with this intervention were examined and potential interfering factors evaluated. Rates and clinical characteristics of candidaemias and other blood stream infections (BSIs) in abdominal surgery patients were compared before (1 January 2006 to 30 June 2007) and after the intervention (1 January 2008 to 30 June 2009). The departments�� activity was LMTK2 assessed by number of bed-days, admissions and surgical procedures, and the consumption of antifungals was analysed. The candidaemia rate decreased from 1.5/1000 admissions in the pre-intervention to 0.3/1000 admissions in the post-intervention period (p 0.002). Numbers of BSIs and bed-days remained stable, and numbers of admissions and surgical procedures performed increased during the study period. Fluconazole consumption in the two abdominal surgery departments increased from 4.6 to 12.2 defined daily doses per 100 bed-days (p?Selleckchem Romidepsin strains (14/29 pre- and 2/7 post-intervention, p 0.43). The introduction of fluconazole prophylaxis was followed by a significantly decreased candidaemia rate. However, the observational study design does not allow conclusions regarding causality. No increase in resistance was detected, but follow-up was short and continuing surveillance is needed. Invasive Candida infections are frequently observed in critically ill patients and are associated with high mortality and costs [1�C4]. The source of candidaemia can frequently be related to the gastrointestinal system, and abdominal surgery is an important risk factor [2,5]. Diagnosis is often dependant on cultures and therefore delayed. Early treatment is crucial, because delayed treatment is associated with increased NLG919 mouse mortality [6,7]. Prophylactic antifungal therapy in abdominal surgery and critically ill patients has been shown to reduce rates of invasive Candida infections in several randomized controlled trials [8�C10]. However, other studies failed to detect a significant effect [11�C13]. Inclusion criteria and antifungal regimen in these studies varied substantially and meta-analyses reached conflicting results regarding the effect on mortality [14�C16]. Another approach, pre-emptive therapy based on a Candida colonization index has been shown to reduce Candida infections [17], but is labour intensive. Finally, empiric therapy in post-operative and intensive care unit (ICU) patients has been studied showing differing results [18,19].