Erschienen in:
01.07.2003 | Correspondence
Comment on "Prevention of severe Candida infections in non-neutropenic, high-risk, critically ill patients," by Garbino et al.
verfasst von:
H. K. F. van Saene, L. Silvestri, A. Petros, M. Viviani, M. A. de la Cal, D. F. Zandstra
Erschienen in:
Intensive Care Medicine
|
Ausgabe 7/2003
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Excerpt
Sir: We read with interest the description by Garbino et al. [
1] purporting to evaluate a randomised, double-blind, placebo-controlled trial in patients treated with selective digestive decontamination (SDD) in an attempt to prevent severe
Candida infections in nonneutropenic, high-risk, critically ill patients. However, the title is very misleading for three reasons: (a) severe
Candida infections were
not prevented, (b) patients were
not treated with SDD, and (c) the intervention assessed is
not mentioned. The manoeuvre studied in this trial was systemic fluconazole vs. placebo. Patients did not receive SDD but solely oropharyngeal decontamination using an antimicrobial solution without an antifungal [
2]. Intestinal decontamination was not administered to any patients. Most importantly, severe
Candida infections, the primary endpoint of the study, were not prevented by fluconazole, as the study was underpowered to one-half the 10% severe infection rate. More than 500 patients per arm would have been required to give the trial a power of 85% [
3]. …