Evaluation of clinical outcomes of anidulafungin for the treatment of candidemia in hospitalized critically ill patients with obesity: A multicenter, retrospective cohort study

Abstract

Objectives: To evaluate the clinical outcomes of anidulafungin for candidemia treatment in critically ill patients with obesity.

Methods: A multicenter, retrospective cohort study was conducted in Saudi Arabia for critically ill adults with candidemia who received anidulafungin. Patients with obesity have a body mass index ≥30 kg/m². The primary outcome was the clinical cure rate.

Results: A total of 146 patients were included, 64 of whom were obese. There were no statistically significant differences in the clinical cure rate (P = 0.63), microbiological cure rate (P = 0.27), or the median time for a clinical cure (P = 0.13) for patients with obesity compared to non-obese patients. The median time for a microbiological cure was longer in non-obese patients than in patients with obesity (P = 0.04). The median hospital length of stay and the median mechanical ventilation durations were numerically longer in patients with obesity.

Conclusions: Clinical and microbiological cure rates and time for clinical cure were statistically similar for both groups. Considering the study's limitations (especially with a small sample size), it is uncertain if patients with obesity have similar effectiveness to non-obese patients. Future studies with larger sample sizes are warranted to evaluate if obesity negatively impacts anidulafungin's clinical outcomes for candidemia.

Keywords: Anidulafungin; Candidemia; Echinocandin; Obesity.