Creation and internal validation of a clinical predictive model for fluconazole resistance in patients with Candida bloodstream infection

BACKGROUND: Fluconazole is recommended as first-line therapy for candidemia when risk of fluconazole resistance (fluc-R) is low. Lack of methods to estimate resistance risk results in extended use of echinocandins and prolonged hospitalization. This study aimed to develop a clinical predictive model to identify patients at low risk for fluc-R where initial or early step-down fluconazole would be appropriate. METHODS: Retrospective analysis of hospitalized adult patients with positive blood culture for RESULTS: We identified 539 adults with candidemia and 72 CONCLUSIONS: This model is a potential tool for identifying patients at low risk for fluc-R candidemia to receive first-line or early step-down fluconazole