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PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
7
pubmed:dateCreated
2004-6-24
pubmed:abstractText
Fluconazole is widely used in the intensive care unit for prevention and treatment of fungal infections. Case reports have described an association between fluconazole and adrenal dysfunction, an important cause of morbidity and mortality in critically ill patients. We sought to determine whether 400 mg of fluconazole per day administered to critically ill surgical patients was associated with a reduction in cortisol levels. Cortisol levels were measured in stored plasma specimens drawn from 154 critically ill surgical patients randomized in 1998-1999 to receive fluconazole or placebo for the prevention of candidiasis. The primary outcome measure was the median plasma cortisol level > or =1 day after study drug initiation (MPCL). Secondary outcomes were adrenal dysfunction, defined as an MPCL of <15 microg/dl, changes in cortisol levels over time, and mortality. The median MPCL was 15.75 microg/dl (interquartile range [IQR], 11.65 to 21.33 microg/dl) in 79 patients randomized to fluconazole and 16.71 microg/dl (IQR, 11.67 to 23.00 microg/dl) in 75 patients randomized to placebo (P = 0.52). Patients randomized to fluconazole did not have significantly increased odds of adrenal dysfunction compared to patients randomized to placebo (odds ratio, 0.98; 95% confidence interval, 0.48 to 2.01). Randomization to fluconazole was not associated with a significant difference in cortisol level changes over time. Mortality was not different between patients with and without adrenal dysfunction, nor was it different between patients with adrenal dysfunction who were randomized to fluconazole and those randomized to placebo. Fluconazole prophylaxis in this population of critically ill surgical patients did not result in significant adrenal dysfunction.
pubmed:grant
pubmed:commentsCorrections
http://linkedlifedata.com/resource/pubmed/commentcorrection/15215096-10066533, http://linkedlifedata.com/resource/pubmed/commentcorrection/15215096-10081637, http://linkedlifedata.com/resource/pubmed/commentcorrection/15215096-10386258, http://linkedlifedata.com/resource/pubmed/commentcorrection/15215096-10397206, http://linkedlifedata.com/resource/pubmed/commentcorrection/15215096-10421297, http://linkedlifedata.com/resource/pubmed/commentcorrection/15215096-10426160, http://linkedlifedata.com/resource/pubmed/commentcorrection/15215096-10577295, http://linkedlifedata.com/resource/pubmed/commentcorrection/15215096-10923728, http://linkedlifedata.com/resource/pubmed/commentcorrection/15215096-11243973, http://linkedlifedata.com/resource/pubmed/commentcorrection/15215096-11279645, http://linkedlifedata.com/resource/pubmed/commentcorrection/15215096-11303137, http://linkedlifedata.com/resource/pubmed/commentcorrection/15215096-11373442, http://linkedlifedata.com/resource/pubmed/commentcorrection/15215096-11418877, http://linkedlifedata.com/resource/pubmed/commentcorrection/15215096-11422002, http://linkedlifedata.com/resource/pubmed/commentcorrection/15215096-11435198, http://linkedlifedata.com/resource/pubmed/commentcorrection/15215096-11685296, http://linkedlifedata.com/resource/pubmed/commentcorrection/15215096-11759644, http://linkedlifedata.com/resource/pubmed/commentcorrection/15215096-11815273, http://linkedlifedata.com/resource/pubmed/commentcorrection/15215096-11942861, http://linkedlifedata.com/resource/pubmed/commentcorrection/15215096-12173140, http://linkedlifedata.com/resource/pubmed/commentcorrection/15215096-12185444, http://linkedlifedata.com/resource/pubmed/commentcorrection/15215096-12186604, http://linkedlifedata.com/resource/pubmed/commentcorrection/15215096-12297992, http://linkedlifedata.com/resource/pubmed/commentcorrection/15215096-12426284, http://linkedlifedata.com/resource/pubmed/commentcorrection/15215096-12447512, http://linkedlifedata.com/resource/pubmed/commentcorrection/15215096-12594318, http://linkedlifedata.com/resource/pubmed/commentcorrection/15215096-1480876, http://linkedlifedata.com/resource/pubmed/commentcorrection/15215096-1542320, http://linkedlifedata.com/resource/pubmed/commentcorrection/15215096-2705831, http://linkedlifedata.com/resource/pubmed/commentcorrection/15215096-2848984, http://linkedlifedata.com/resource/pubmed/commentcorrection/15215096-3038002, http://linkedlifedata.com/resource/pubmed/commentcorrection/15215096-3702414, http://linkedlifedata.com/resource/pubmed/commentcorrection/15215096-3831227, http://linkedlifedata.com/resource/pubmed/commentcorrection/15215096-3981770, http://linkedlifedata.com/resource/pubmed/commentcorrection/15215096-6092411, http://linkedlifedata.com/resource/pubmed/commentcorrection/15215096-6093722, http://linkedlifedata.com/resource/pubmed/commentcorrection/15215096-6287893, http://linkedlifedata.com/resource/pubmed/commentcorrection/15215096-6304148, http://linkedlifedata.com/resource/pubmed/commentcorrection/15215096-6325910, http://linkedlifedata.com/resource/pubmed/commentcorrection/15215096-7769290, http://linkedlifedata.com/resource/pubmed/commentcorrection/15215096-7872343, http://linkedlifedata.com/resource/pubmed/commentcorrection/15215096-8323597, http://linkedlifedata.com/resource/pubmed/commentcorrection/15215096-8396204, http://linkedlifedata.com/resource/pubmed/commentcorrection/15215096-9003254, http://linkedlifedata.com/resource/pubmed/commentcorrection/15215096-9345079
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Jul
pubmed:issn
0066-4804
pubmed:author
pubmed:issnType
Print
pubmed:volume
48
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
2471-6
pubmed:dateRevised
2009-11-18
pubmed:meshHeading
pubmed:year
2004
pubmed:articleTitle
Impact of fluconazole prophylaxis on cortisol levels in critically ill surgical patients.
pubmed:affiliation
Division of Infectious Diseases, Johns Hopkins University School of Medicine, 1830 E. Monument St., Suite 463A, Baltimore, MD 21287, USA. ssylvester99@yahoo.com
pubmed:publicationType
Journal Article, Clinical Trial
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