Efficacy and safety of antifungal prophylaxis in surgical intensive care unit patients: A systematic review and meta‑analysis of randomized controlled trials
Rattachement africain : id, jp. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
Invasive fungal infections (IFIs) are serious complications among surgical intensive care unit (ICU) patients, leading to substantial morbidity and mortality. Antifungal prophylaxis and pre-emptive strategies are employed to reduce the risk of such infections, although their effectiveness and safety remain subjects of debate. The present systematic review and meta-analysis included randomized controlled trials evaluating antifungal prophylaxis or pre-emptive therapy in surgical ICU patients. Searches in the PubMed, Scopus, Google Scholar and Science Direct databases up to February 2025 identified 11 eligible studies. Pooled analyses demonstrated that antifungal prophylaxis significantly reduced the risk of IFIs [risk ratio (RR)=0.63; 95% CI, 0.50-0.78; P<0.0001]. While azoles were effective, polyenes and echinocandins did not show a significant effect. No significant effect on overall mortality was observed (RR=0.99; 95% CI, 0.75-1.31; P=0.9186), and there was no increased risk of severe adverse events (RR=0.98; 95% CI, 0.70-1.36) or liver dysfunction (RR=0.91; 95% CI, 0.31-2.65). The analysis did not reveal strong evidence of publication bias as evaluated by funnel plots. Overall, the results indicated that antifungal prophylaxis appeared to be effective in reducing the risk of IFIs in surgical ICU patients without elevating the risk of serious side effects. The implementation of this therapy should be targeted toward high-risk populations, considering the antifungal type, local resource availability and antimicrobial management parameters. The evidence of prophylaxis therapy in low-risk population is limited, since the majority of included studies in the present meta-analysis analyzed high-risk populations.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Efficacy and safety of antifungal prophylaxis in surgical intensive care unit patients: A systematic review and meta‑analysis of randomized controlled trials
- Date Crossref
- 23/03/2026
- Éditeur
- Spandidos Publications
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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Airlangga University pays non établi dans la noticeUniversité ou école supérieure
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Sam Ratulangi University pays non établi dans la noticeUniversité ou école supérieure
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University of Nagasaki pays non établi dans la noticeUniversité ou école supérieure
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Nagasaki University pays non établi dans la noticeUniversité ou école supérieure
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Faculty of Medicine Department of Medical Microbiology pays non établi dans la noticeUniversité ou école supérieure
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Faculty of Health Department of Medicine pays non établi dans la noticeUniversité ou école supérieure
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Graduate School of Biomedical Sciences Department of Integrative Neuroscience pays non établi dans la noticeUniversité ou école supérieure
Airlangga University, Sam Ratulangi University et University of Nagasaki, avec 4 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.