ABSTRACT
Background: Delay in treatment of candidaemia and invasive candidiasis remains a cause of significant morbidity and mortality in high-risk patients. Widespread empirical utilization of antifungal therapy often occurs in an effort to minimize this risk. Objectives: This study assessed the impact of the T2Candida Panel in a multi-hospital community health system on time to initiation of antifungal therapy in candidaemic patients as well as the utilization of micafungin. Methods: Outcomes were compared between those patients with candidaemia prior to T2Candida implementation and those after implementation. Micafungin utilization for patients with suspected candidaemia/invasive candidiasis was compared with that for patients with a negative T2Candida Panel post-implementation. Results: There was a significant decrease in time to appropriate therapy in the post-T2Candida group (34 versus 6 h, P = 0.0147). Empirical antifungal therapy was avoided in 58.4% of T2Candida-negative patients. Conclusions: These results support the implementation of T2Candida to improve time to appropriate therapy for candidaemic patients while simultaneously expanding antimicrobial stewardship efforts to appropriately utilize antifungals.
Subject(s)
Antifungal Agents/therapeutic use , Candida/classification , Candida/isolation & purification , Candidemia/diagnosis , Candidemia/drug therapy , Candidiasis, Invasive/diagnosis , Candidiasis, Invasive/drug therapy , Micafungin/therapeutic use , Adult , Aged , Aged, 80 and over , Antimicrobial Stewardship , Candidemia/diagnostic imaging , Candidiasis, Invasive/diagnostic imaging , Community Health Centers , Female , Humans , Male , Middle Aged , Retrospective StudiesABSTRACT
The relation between sequential request influence strategies and social power was examined, using a social impact theory model of perception. It was predicted that a door-in-the-face (DITF) scenario would suggest a greater difference in power between a giver and seeker than a foot-in-the-door (FITD) scenario would. Two judgment studies using American students at two different universities measured the perceived power of two individuals, the favor giver and the favor seeker, in either the DITF or the FITD. In both studies, the subjects perceived a significantly greater power difference between the giver and the seeker in the DITF strategy than they did in the FITD.