INTRAVASCULAR CATHETER EXCHANGE AND DURATION OF CANDIDEMIA

During a comparative trial of amphotericin B vs, fluconazole for treat ment of candidemia in nonneutropenic patients, data on the management of intravascular catheters were collected, Complete records were avail able for 91% of the 206 study patients, For the subset of patients wit h a catheter in place at the time of their first positive blood cultur e, removal and replacement of all intravascular catheters without exch ange over a guidewire from a preexisting line on or before the first d ay the study drug was administered were associated with a reduction in the subsequent mean duration (+/- SE) of candidemia, from 5.6 +/- 0.8 days to 2.6 +/- 0.5 days (P < .001).