Annals of Pharmacotherapy最新文献

{"title":"Variables Associated With Poor Clinical Outcomes in Patients With Serious Fluconazole Non-Susceptible <i>Candida Species</i> Infections.","authors":"Chris A Gentry, Cailyn Evans, Sharanjeet Thind, Riley J Williams","doi":"10.1177/10600280261429453","DOIUrl":"10.1177/10600280261429453","url":null,"abstract":"<p><strong>Background: </strong>Antifungal resistance among <i>Candida species</i> has become increasingly prevalent in recent years.</p><p><strong>Objectives: </strong>This study aims to identify independent predictors for poor outcomes associated with serious clinical infections caused by fluconazole non-susceptible <i>Candida</i> sp. across the Veterans Health Administration.</p><p><strong>Methods: </strong>This retrospective, observational, nationwide analysis included adults admitted to any Veterans Affairs Medical Center (VAMC) between January 1, 2009, and September 30, 2024, with positive cultures (or rapid diagnostic test) for <i>Candida</i> sp. from otherwise-sterile sites. Multivariate logistic regression assessed associations with the 30-day mortality in patients with these <i>Candida</i> sp. infections, regardless of fluconazole susceptibility.</p><p><strong>Results: </strong>Eligible cases were found from 1613 patients with 1651 culture episodes from otherwise-sterile sites detecting <i>Candida</i> sp. with available fluconazole susceptibility data. Non-susceptible <i>Candida</i> sp. was discovered in 261 of these episodes. Independent variables associated with 30-day mortality in fluconazole non-susceptible infection included reduced serum bicarbonate, thrombocytopenia, recent exposure to the macrolide/tetracycline/clindamycin antibiotics, elevated blood urea nitrogen, and lack of recent outpatient surgery. In the propensity-matched comparison, 30-day mortality between the 2 groups was not statistically significant: 26.6% for episodes with susceptible fluconazole isolates vs 24.9% for non-susceptible episodes (139/522 vs 65/251; P = 0.60).</p><p><strong>Conclusion and relevance: </strong>Several host-derived physiological markers and recent exposure to protein synthesis inhibitor antibiotics were independent variables associated with 30-day mortality in patients with non-susceptible serious <i>Candida</i> sp.</p><p><strong>Infections: </strong>This information may guide clinicians toward strategies to improve the clinical outcomes of these patients.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"1182-1188"},"PeriodicalIF":2.5,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147503035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Non-benzodiazepine Versus Benzodiazepine Sedation on Days Alive and Free of Mechanical Ventilation in the Surgical/Trauma Intensive Care Unit.","authors":"Travis VanOtterloo, Kyllie Ryan-Hummel, Rebecca Attridge, Dana Foster, Susannah Nicholson, Jacob Tondre, Savanna Pittman, Sarah Berman","doi":"10.1177/10600280261433047","DOIUrl":"10.1177/10600280261433047","url":null,"abstract":"<p><strong>Background: </strong>Data comparing benzodiazepine (BZD) to nonbenzodiazepine (non-BZD) sedatives in patients on mechanical ventilation (MV) demonstrate non-BZD sedation is associated with reduced duration of MV and lower mortality and delirium rates in medical and cardiac intensive care unit (ICU) populations. Limited data exist in surgical/trauma ICU (STICU) populations.</p><p><strong>Objective: </strong>Evaluate BZD versus non-BZD sedation on days alive and free of MV at 28 days in STICU patients.</p><p><strong>Methods: </strong>This single-center, institutional review board-approved, retrospective cohort study evaluated adult patients admitted to the STICU, intubated for ≥24 hours, and required continuous non-BZD versus BZD sedation in a level I trauma academic hospital. Primary outcome was days alive and free of MV at 28 days. Secondary outcomes included percent of time patients were oversedated and rates of delirium and ventilator-associated pneumonia (VAP). A multivariable model was constructed to determine independent predictors of being alive and free of MV at 28 days.</p><p><strong>Results: </strong>After screening, 209 patients were included (BZD, n = 88; non-BZD, n = 121). BZD patients had higher Charlson comorbidity index (CCI) and APACHE II scores. Non-BZD patients had higher rates of traumatic brain injury. Patients receiving non-BZD sedation experienced more days alive and free of MV at 28 days compared with BZD sedation (24 [interquartile range, IQR = 22-25] vs 24 [IQR = 20-25]; <i>P</i> = 0.002). In a multivariable model, including APACHE II score and CCI, non-BZD sedation remained independently associated with increased odds of being alive and free of MV at 28 days (adjusted odds ratio: 6.98; <i>P</i> = 0.002). In addition, non-BZD sedation was associated with less time being oversedated (<i>P</i> < 0.0001), less delirium (<i>P</i> = 0.003), and lower rates of VAP (<i>P</i> = 0.0007).</p><p><strong>Conclusions and relevance: </strong>In STICU patients requiring MV, non-BZD sedation was associated with more ventilator-free days, less time oversedated, reduced delirium, and reduced VAP. These findings extend prior ICU sedation data into the STICU population supporting the use of non-BZD strategies when clinically appropriate to optimize patient outcomes.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"1137-1146"},"PeriodicalIF":2.5,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147621364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy, Safety, and Tolerability of Secukinumab in Psoriatic Arthritis: A Systematic Review and Meta-Analysis.","authors":"Muhammad Saad Khan, Saim Mahmood Khan, Rabia Farooq, Aliza Arif, Abiha Murshid, Muhammad Abdullah, Ayesha Ismail, Jawairya Muhammad Hussain, Shayan Rahim, Syeda Neha Ahmed, Surraiya Riaz Mahmood Khan","doi":"10.1177/10600280261442115","DOIUrl":"10.1177/10600280261442115","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the efficacy and safety of secukinumab in patients with active psoriatic arthritis (PsA) through a systematic review and meta-analysis of randomized controlled trials (RCTs).</p><p><strong>Data sources: </strong>A comprehensive literature search of PubMed, Embase, Cochrane Library, and ClinicalTrials.gov was conducted from inception until February 2026 to identify relevant RCTs.</p><p><strong>Study selection and data extraction: </strong>Eligible studies included randomized, placebo-controlled trials assessing secukinumab in adults with active PsA. Two independent reviewers screened studies, extracted data on clinical efficacy (American College of Rheumatology [ACR] 20/50 responses, Health Assessment Questionnaire-Disability Index [HAQ-DI]) and safety outcomes (overall adverse events [AEs], infections, and treatment discontinuation) and assessed the risk of bias.</p><p><strong>Data synthesis: </strong>Pooled analyses demonstrated that secukinumab significantly improved ACR20 and ACR50 response rates and reduced HAQ-DI scores compared with placebo. Dose-related trends suggested greater efficacy with the 300 mg regimen for selected outcomes. Safety analysis showed no significant increase in overall AEs, upper respiratory tract infections, or discontinuations compared with placebo.</p><p><strong>Relevance to patient care and clinical practice: </strong>These findings support secukinumab as an effective and well-tolerated biologic therapy, particularly for patients with an inadequate response to conventional disease-modifying antirheumatic drugs or tumor necrosis factor inhibitors, thereby facilitating individualized treatment strategies.</p><p><strong>Conclusions: </strong>Secukinumab is associated with significant clinical and functional benefits and demonstrates a favorable safety profile, reinforcing its role in optimizing long-term disease control in active PsA.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"1103-1117"},"PeriodicalIF":2.5,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147925751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Rate Versus Rhythm Control in Patients With New-Onset Atrial Fibrillation on 30-Day Outcomes.","authors":"Zackery D Rodriguez, Thomas W Szymanski, Sudarshan Balla, Jordan L Lacoste","doi":"10.1177/10600280261421569","DOIUrl":"10.1177/10600280261421569","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) is associated with an increased risk of stroke and heart failure (HF). Historically, rate control has been the preferred treatment strategy due to fewer adverse drug events, but emerging evidence suggests early rhythm control may offer mortality benefits. Despite this, a critical gap exists in understanding short-term outcomes of rhythm control.</p><p><strong>Objectives: </strong>Assess the impact of early rhythm control strategy in patients with new-onset AF on mortality, hospitalizations, or emergency room (ER) visits compared to rate control strategy.</p><p><strong>Methods: </strong>Retrospective observational study of patients at least 18 years of age diagnosed with new-onset AF cared for in a large United States healthcare system. Patients with identifiable triggers were excluded. The primary outcome was rates of all-cause mortality, hospitalization, or ER visit for AF, atrial flutter (AFL), or HF at 30 days.</p><p><strong>Results: </strong>Four hundred sixty-three patients were included, 278 in the rate control group and 185 in the rhythm control group. The median follow-up duration across groups was 654.5 days. At 30 days post-diagnosis, the rate control group experienced a higher rate of the primary outcome (19.8% vs. 11.9%, <i>P</i> = 0.027). Cox proportional hazards model demonstrated that rhythm control was associated with a reduced risk of experiencing the secondary outcome (HR 0.759, 95% CI [0.582, 0.984], <i>P</i> = 0.042).</p><p><strong>Conclusion and relevance: </strong>In patients with new-onset AF, early rhythm control was associated with a lower incidence of all-cause mortality, hospitalization, or ER visits. These findings underscore the importance of rhythm control in optimizing early AF management and improving patient outcomes.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"1037-1047"},"PeriodicalIF":2.5,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147442244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Determinants of Early Achievement of the Therapeutic Teicoplanin Trough Concentration Range in Adult Cancer Patients.","authors":"Toshihisa Nakashima, Osamu Kobayashi, Mika Shiotsuka, Keiji Okinaka, Hironobu Hashimoto","doi":"10.1177/10600280261421670","DOIUrl":"10.1177/10600280261421670","url":null,"abstract":"<p><strong>Background: </strong>Teicoplanin is widely used to treat Gram-positive infections in adult cancer patients, but early attainment of recommended trough concentrations and clinical determinants of those concentrations are not well characterized in patients receiving standardized, high-dose loading regimens.</p><p><strong>Objective: </strong>This study aimed to characterize day 4 teicoplanin trough concentrations and to identify clinical predictors of under- and over-target levels in adult cancer patients receiving a standardized high-dose loading regimen.</p><p><strong>Methods: </strong>This retrospective study included adult cancer patients who received a standardized high-dose teicoplanin loading regimen (600 mg intravenously twice daily on days 1-2 and once on day 3) and had a post-loading trough measurement on day 4. Patients were classified as under (< 20 mg/L), within (20-30 mg/L), or over target (> 30 mg/L). Clinical variables were compared across groups, and multivariable Firth-penalized logistic regression analysis was used to identify factors associated with under- and over-target trough concentrations vs within-target ones.</p><p><strong>Results: </strong>The study included 211 patients: 71 (33.6%) in the under-, 112 (53.1%) in the within-, and 28 (13.3%) in the over-target group. Higher body weight and febrile neutropenia were associated with higher odds of under-target trough concentrations, whereas higher serum albumin was associated with lower odds; febrile neutropenia was associated with lower odds of over-target concentrations.</p><p><strong>Conclusion and relevance: </strong>The fixed high-dose loading regimen of teicoplanin evaluated in this study achieves a day 4 trough concentration of 20 to 30 mg/L in about half of adult cancer patients. Higher body weight, febrile neutropenia, and lower serum albumin may help identify patients who require intensified loading and early therapeutic drug monitoring.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"1075-1082"},"PeriodicalIF":2.5,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146225194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacy Technician Impact on Access to High-Cost Heart Failure Pharmacotherapy.","authors":"Morgan S Augustine, Erika Nicolsen, Alexander Reed, Alice Parish, Alaattin Erkanli, Oksana Kamneva","doi":"10.1177/10600280261418735","DOIUrl":"10.1177/10600280261418735","url":null,"abstract":"<p><strong>Background: </strong>It is challenging for patients with heart failure to obtain all core classes of guideline-directed medical therapy (GDMT), especially because sacubitril-valsartan and sodium-glucose cotransporter 2 inhibitors (SGLT2i) are cost-prohibitive for many. Pharmacy technicians in an outpatient heart failure clinic can provide support for medication access.</p><p><strong>Objective: </strong>The objective of this study was to determine the impact of a pharmacy technician on access to high-cost GDMT for patients with heart failure.</p><p><strong>Methods: </strong>This retrospective, pre-post cohort study evaluated adults with heart failure who were eligible for treatment with both sacubitril-valsartan and SGLT2i and had a heart failure clinic visit prior to the addition of a pharmacy technician (September 1, 2022, through February 28, 2023) or after the addition (September 1, 2023, through February 29, 2024). Excluded patients were pregnant, incarcerated, Veterans Affairs patients, had an estimated glomerular filtration rate <20 mL/min/1.73 m², or received a heart transplant. The primary composite outcome was a binary variable identifying if patients were prescribed and filled sacubitril-valsartan and/or SGLT2i, evaluated using logistic regression controlling for patient prescription drug coverage. Secondary outcomes included affordable access to ivabradine and vericiguat and 30-day hospitalization rate. Pharmacy technician time spent was evaluated in the post-cohort.</p><p><strong>Results: </strong>There were 192 patients included; 96 in each cohort. Access to sacubitril-valsartan and/or SGLT2i increased from 71.9% pre-cohort to 86.5% post-cohort (OR = 2.46, 95% CI = [1.18, 5.34]; <i>P</i> = 0.02). No differences were observed in secondary outcomes. The pharmacy technician spent an average of 66.4 minutes per patient assisted (n = 21/96).</p><p><strong>Conclusion and relevance: </strong>This study demonstrated a significant increase in access to sacubitril-valsartan and/or SGLT2i after the implementation of a pharmacy technician. Larger, prospective studies are needed to evaluate the impact of a pharmacy technician on clinical outcomes in this population.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"1083-1089"},"PeriodicalIF":2.5,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146225148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of Prophylactic Use of NSAIDs on Acute Phase Reactions Induced by First-Time Zoledronic Acid Treatment for Osteoporosis.","authors":"Qiuling Wang, Weiyang Zhang, Wencan Lu, Weipeng Ai","doi":"10.1177/10600280251367582","DOIUrl":"10.1177/10600280251367582","url":null,"abstract":"<p><strong>Background: </strong>Zoledronic acid is a first-line treatment for primary osteoporosis, but its high acute-phase-reaction (APR) incidence can reduce patient compliance and long-term efficacy. Non-steroidal anti-inflammatory drugs (NSAIDs), with antipyretic and analgesic effects, can relieve APR symptoms like fever and muscle soreness caused by zoledronic acid. However, the role of prophylactic NSAID use in decreasing APRs remains controversial.</p><p><strong>Objective: </strong>This study aims to evaluate the impact of NSAIDs on preventing zoledronic acid-related APRs to guide clinical practice.</p><p><strong>Methods: </strong>Retrospective data of osteoporosis patients receiving zoledronic acid injection at Shenzhen University General Hospital from January 2023 to December 2024 were collected. A 1:2 propensity score matching (PSM) compared the APR incidences between the non-NSAIDs and NSAIDs groups.</p><p><strong>Results: </strong>Among 351 cases (98 non-NSAIDs, 253 NSAIDs), 200 cases (79 non-NSAIDs, 121 NSAIDs) remained after PSM. The NSAIDs group had a lower overall APR incidence (38.0% vs. 53.2%, <i>χ</i>² = 4.451, <i>P</i> = .035). There was no significant difference in fever incidence (χ2 = 1.888, <i>P</i> = .169), but pain incidence was lower in the NSAIDs group (25.3% vs. 9.9%, <i>χ</i>² = 8.433, <i>P</i> = .004). Flurbiprofen axetil, ibuprofen, and etoricoxib showed similar APR-preventive effects.</p><p><strong>Conclusion and relevance: </strong>Prophylactic NSAIDs significantly reduce zoledronic acid-induced APRs, especially pain, but have no significant effect on preventing fever. The 3 NSAIDs also have comparable efficacy.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"1048-1057"},"PeriodicalIF":2.5,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145297947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re: Evaluation of Symptom-Triggered Benzodiazepines Versus Phenobarbital for Alcohol Withdrawal Syndrome in Trauma-Surgical Intensive Care Patients.","authors":"Taylor M Law","doi":"10.1177/10600280261444365","DOIUrl":"10.1177/10600280261444365","url":null,"abstract":"","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"1132"},"PeriodicalIF":2.5,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147759818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Nutritional Status and Body Composition on Osimertinib Tolerance in Non-Small-Cell Lung Cancer.","authors":"Claudia Barca-Díez, Lara González-Freire, Borja Franco-Sandar","doi":"10.1177/10600280261438838","DOIUrl":"10.1177/10600280261438838","url":null,"abstract":"","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"1130"},"PeriodicalIF":2.5,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors for the Development of Invasive Infection of Fluconazole Non-Susceptible or Echinocandin Non-Susceptible <i>Candida Species</i> Across the Veterans Health Administration.","authors":"Cailyn Evans, Riley J Williams, Sharanjeet Thind, Chris A Gentry","doi":"10.1177/10600280261424286","DOIUrl":"10.1177/10600280261424286","url":null,"abstract":"<p><strong>Background: </strong>Antifungal-resistant <i>Candida species</i> have become increasingly prevalent in recent years, posing significant therapeutic challenges in the inpatient setting. Despite their clinical relevance, comprehensive data evaluating risk factors for the development of invasive infections caused by <i>Candida</i> sp. with antifungal resistance are limited.</p><p><strong>Objective: </strong>This study aims to identify independent predictors for the development of invasive clinical infections caused by fluconazole-resistant or echinocandin-resistant <i>Candida</i> sp. in hospitalized veterans across the United States Veterans Health Administration.</p><p><strong>Methods: </strong>This retrospective, observational, nationwide analysis included adults ≥18 years admitted to any Veterans Affairs Medical Center between January 1, 2009, and September 30, 2024, with culture-positive or rapid diagnostic test-confirmed invasive <i>Candida</i> sp. infection from otherwise-sterile sites. Data were gathered on baseline demographics, baseline laboratory data, comorbid conditions, and exposure to antibacterial agents, antifungal agents, β-Hydroxy β-methylglutaryl-CoA (HMG-CoA) reductase inhibitors, and immunosuppressant drug therapy. Univariate and multivariate logistic regression models were used to assess associations between clinical variables and the development of invasive fluconazole-resistant and echinocandin-resistant <i>Candida</i> sp.</p><p><strong>Infections: </strong></p><p><strong>Results: </strong>Eligible cases were found from 25 Veterans Affairs Medical Center facilities; 1651 episodes had available fluconazole susceptibility data, and 1117 episodes had echinocandin susceptibility data. Fluconazole non-susceptibility was independently associated with at least 7 days of recent exposure to either fluconazole or an echinocandin, among a few other variables. Echinocandin resistance, while less common, was strongly linked to the receipt of dialysis, prolonged Gram-positive antibacterial exposure, and any prior antifungal use.</p><p><strong>Conclusions and relevance: </strong>These findings can inform antifungal stewardship efforts to curb the rise of resistant <i>Candida</i> sp.</p>","PeriodicalId":7933,"journal":{"name":"Annals of Pharmacotherapy","volume":" ","pages":"1058-1065"},"PeriodicalIF":2.5,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147455123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}