Journal article
Empiric Antifungal Therapy Is Not Associated with Improved Infectious Outcomes in Penetrating Upper Gastrointestinal Injuries: A Subgroup Analysis of the Surgical Infection Society Multi-Center Observational Study
Surgical infections, PMID 9815642
01/09/2026
DOI: 10.1177/10962964251412214
Abstract
Background:
The role of empiric antifungal therapy in patients with gastrointestinal (GI) perforations because of penetrating trauma remains unclear. Existing literature suggests minimal benefit in non-traumatic GI perforations. This study aimed to evaluate the association between empiric antifungal use and post-operative infectious complications in patients with upper GI perforations because of penetrating trauma.
Methods:
This was a prospective, multi-center cohort study conducted across 15 institutions between August 2021 and January 2024. We included adult patients with upper GI perforations because of penetrating trauma. The primary outcome was organ/space surgical site infection (SSI) within 30 days. Secondary outcomes included superficial and deep SSI, any SSI (superficial, deep, or organ/space), sepsis, pneumonia, return to the operating room, acute kidney injury (AKI), and in-hospital mortality. Multi-variable logistic regression was used to adjust for confounders.
Results:
A total of 173 patients were included, of whom 23.1% (n = 40) received empiric antifungals. There was no significant difference in the rate of organ/space SSI between patients who received antifungals and those who did not (17.5% vs. 9.8%, p = 0.180). Antifungal use was also not associated with any significant difference in superficial, deep, or any SSI rates. On multi-variable analysis, antifungal therapy was not independently associated with reduced risk of organ/space SSI (odds ratio 1.72, 95% confidence interval 0.58–5.07). Patients who received antifungals had higher rates of sepsis, pneumonia, AKI, return to the operating room, and in-hospital mortality.
Conclusions:
Empiric antifungal therapy was not associated with a reduction in organ/space SSI or any SSI, among patients with penetrating upper GI injuries. Trauma patients with upper GI injuries do not appear to benefit from empiric antifungal coverage.
Details
- Title: Subtitle
- Empiric Antifungal Therapy Is Not Associated with Improved Infectious Outcomes in Penetrating Upper Gastrointestinal Injuries: A Subgroup Analysis of the Surgical Infection Society Multi-Center Observational Study
- Creators
- Vahe S. Panossian - Massachusetts General HospitalYasmin Arda - Massachusetts General HospitalWardah Rafaqat - Massachusetts General HospitalAndrea M. GochiMira Ghneim - University of Maryland, BaltimoreSeema Anandalwar - Penn Center for AIDS ResearchDias ArgandykovCynthia Susai - University of California, San FranciscoNathan AlcasidGeoffrey A. Anderson - Brigham and Women's HospitalAlexander J. Ordoobadi - Brigham and Women's HospitalErik J. TeicherDavid P. Blake - Inova Fairfax HospitalBrendin R. Beaulieu-Jones - Boston Medical CenterSabrina E. Sanchez - Boston Medical CenterChristopher A. Guidry - University of Kansas Medical CenterPedro TeixeiraJonathan MeizosoBrianna L. CollieSarah McWilliamPatrick McGonagill - University of IowaNicole Nitschke - University of Iowa Hospitals and ClinicsColete Galet - University of Iowa Hospitals and ClinicsLillian Nefcy - Henry Ford HospitalJeffrey L. Johnson - Henry Ford HospitalMichael P. DeWaneJoseph Cuschieri - University of California, San FranciscoAmber Himmler - University of California, San FranciscoJennifer Rickard - University of MinnesotaJonathan Gipson - University of MinnesotaApril E. Mendoza
- Resource Type
- Journal article
- Publication Details
- Surgical infections, PMID 9815642
- DOI
- 10.1177/10962964251412214
- ISSN
- 1096-2964
- eISSN
- 1557-8674
- Publisher
- Sage
- Language
- English
- Electronic publication date
- 01/09/2026
- Academic Unit
- Surgery; University of Iowa Health Care
- Record Identifier
- 9985121502402771
Metrics
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