An observational study in Invasive Fungal Disease and Critical Illness, sponsored by University Hospital, Lille. Completed at 1 site in France. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2025-12-23.
Sponsored by University Hospital, Lille · Observational
A small proportion of intensive care unit patients receiving antifungals have a proven invasive fungal infection. However, antifungal treatment has side effects such as toxicity, emergence of resistance, and high cost. Moreover, empirical antifungal treatment is still a matter for debate in these patients. Our study aimed to determine the incidence, associated factors, and safety of de-escalation of antifungals in immunocompromised critically ill patients.
This prospective observational study is conducted in 14 ICU, during a 6 months period. All immunocompromised patients hospitalized for >5d and treated with antifungals for suspected or proven invasive candida infection will be included De-escalation is defined as a reduction in antifungal spectrum or stopping initial drugs within the 5 days following their initiation. The three antifungals considered in this study are from the narrowest to the widest spectrum: fluconazole, caspofungin and liposomal amphotericin B.
This is a retrospective and prospective observational multicenter study, aiming to determine the incidence, and safety of antifungal de-escalation in immunocompromised patients, and also factors associated with de-escalation.
146 studies on the registry are indexed under Invasive Fungal Infections; 35 are open to participants now.
This study's enrollment of 275 is above the median of 120 across 68 observational studies indexed under Invasive Fungal Infections.
Browse Invasive Fungal Infections studies →University Hospital, Lille is the lead sponsor of 625 studies on the registry; 141 are open to participants now.
Counted across the registry records on this site, refreshed daily.
Adults immunocompromised patients hospitalized in intensive care units (Age ≥18 years)
Immunosuppression is defined by:
Exclusion Criteria:
Percentage of patients with de-escalation of antifungal treatment
De-escalation is defined as a reduction in antifungal treatment spectrum (switch from echinocandines or Amphotericin B to Azoles) or stopping all antifungals within the 5 days following their initiation
Time frame: 5 days following start of antifungal treatment
Risk factors for de-escalation of antifungal therapy
Clinical characteristics and conditions significantly associated with de-escalation by univariate analysis will be entered in a multiple regression model to determine those independently associated with de-escalation
Time frame: during the 5 days following start of antifungal
Number of days free of mechanical ventilation
days with no mechanical ventilation
Time frame: until day 28 after start of antifungal treatment
Number of days free of antifungal treatment
days with no antifungal treatment
Time frame: until day 28 after start of antifungal treatment
Length of ICU stay
days in the ICU
Time frame: until day 28 after start of antifungal treatment
All-cause mortality
mortality related to any cause
Time frame: until day 28 after start of antifungal treatment
Percentage of patients with reoccurrence of candidiasis
reccurrence of candidiasis is defined as a new episode after the end of antifungal treatment
Time frame: until day 7 after stop of antifungal treatment
This study is completed, as verified in Dec 2025. You cannot join it, but the record below documents what was studied.
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University Hospital, Lille