Antifungal therapy and length of hospitalization in transplant patients with invasive aspergillosis

John W. Baddley, David R. Andes, Kieren A. Marr, Carol A. Kauffman, Dimitrios P. Kontoyiannis, James I. Ito, Mindy G. Schuster, Kyle D. Brizendine, Thomas F Patterson, G. Marshall Lyon, Michael Boeckh, Robert A. Oster, Tom Chiller, Peter G. Pappas

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

The impact of antifungal therapy on economic outcomes in patients with invasive aspergillosis (IA) needs further exploration. The purpose of this study was to describe antifungal therapy and factors associated with hospital length of stay (LOS) in transplant patients with IA. Patients were enrolled from March 2001 to October 2005 and IA cases identified through March 2006 from a sub-group of patients in the Transplant Associated Infection Surveillance Network (TRANSNET). Factors associated with hospital LOS were determined by logistic regression analysis. Of 361 patients, the mean age was 49 years, 60.7% were male, and 63% were hematopoietic stem cell transplantation (HSCT) recipients. Primary monotherapy was used in 233 (64.5%) patients, of which voriconazole (93/233, 39.9%) was most commonly used antifungal. Primary combination therapy was used in 128 (35.4%) of 361 patients, with voriconazole plus caspofungin (81/361, 22.4%) the most frequently employed. Mean duration of therapy was 115 days (HSCT 109.7; solid organ transplant [SOT] 125.3). Mean hospital LOS was 35.3 days (HSCT 38.7; SOT 29.7). Regression analysis identified disseminated IA, neutropenia, malnutrition and length of ICU stay as factors associated with increased hospital LOS. Initial voriconazole use was associated with decreased LOS. Further investigation on impact of antifungal therapy on economic outcomes is needed.

Original languageEnglish (US)
Pages (from-to)128-135
Number of pages8
JournalMedical Mycology
Volume51
Issue number2
DOIs
StatePublished - Feb 2013
Externally publishedYes

Fingerprint

Aspergillosis
aspergillosis
Length of Stay
Hospitalization
Transplants
therapeutics
cell transplantation
organ transplantation
Hematopoietic Stem Cell Transplantation
Therapeutics
regression analysis
caspofungin
economics
neutropenia
Regression Analysis
Economics
malnutrition
Neutropenia
Malnutrition
duration

Keywords

  • Aspergillosis
  • Aspergillus
  • Combination therapy
  • Voriconazole

ASJC Scopus subject areas

  • veterinary(all)
  • Infectious Diseases

Cite this

Baddley, J. W., Andes, D. R., Marr, K. A., Kauffman, C. A., Kontoyiannis, D. P., Ito, J. I., ... Pappas, P. G. (2013). Antifungal therapy and length of hospitalization in transplant patients with invasive aspergillosis. Medical Mycology, 51(2), 128-135. https://doi.org/10.3109/13693786.2012.690108

Antifungal therapy and length of hospitalization in transplant patients with invasive aspergillosis. / Baddley, John W.; Andes, David R.; Marr, Kieren A.; Kauffman, Carol A.; Kontoyiannis, Dimitrios P.; Ito, James I.; Schuster, Mindy G.; Brizendine, Kyle D.; Patterson, Thomas F; Lyon, G. Marshall; Boeckh, Michael; Oster, Robert A.; Chiller, Tom; Pappas, Peter G.

In: Medical Mycology, Vol. 51, No. 2, 02.2013, p. 128-135.

Research output: Contribution to journalArticle

Baddley, JW, Andes, DR, Marr, KA, Kauffman, CA, Kontoyiannis, DP, Ito, JI, Schuster, MG, Brizendine, KD, Patterson, TF, Lyon, GM, Boeckh, M, Oster, RA, Chiller, T & Pappas, PG 2013, 'Antifungal therapy and length of hospitalization in transplant patients with invasive aspergillosis', Medical Mycology, vol. 51, no. 2, pp. 128-135. https://doi.org/10.3109/13693786.2012.690108
Baddley, John W. ; Andes, David R. ; Marr, Kieren A. ; Kauffman, Carol A. ; Kontoyiannis, Dimitrios P. ; Ito, James I. ; Schuster, Mindy G. ; Brizendine, Kyle D. ; Patterson, Thomas F ; Lyon, G. Marshall ; Boeckh, Michael ; Oster, Robert A. ; Chiller, Tom ; Pappas, Peter G. / Antifungal therapy and length of hospitalization in transplant patients with invasive aspergillosis. In: Medical Mycology. 2013 ; Vol. 51, No. 2. pp. 128-135.
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