FIRE

Fungal Infection Risk Evaluation

Status: Published 

What was this study about?

There is evidence that fungal infections are more likely to occur in patients in critical care units.  A number of research studies have evaluated treatments to prevent fungal infection in critically ill patients, and have shown that these treatments reduce the risk of fungal infection and possibly reduce the number of deaths from fungal infection. 

The aim of the FIRE Study was to develop methods to identify critically ill adult patients at high risk of fungal infection, who would benefit from preventative treatment and to assess the cost-effectiveness of targeting antifungal treatments to high-risk patients. 

96 UK adult general critical care units took part in the study and collected data on 60,778 patients admitted to the critical care unit between July 2009 and March 2011. 

This study used data from the Case Mix Programme and Scottish Intensive Care Society Audit Group. 

What did the study find?

There was a low incidence of fungal infection among critically ill adult patients. However the death rate was higher in those patients with fungal infection.  The study found that the most cost-effective treatment strategy for critically ill adult patients admitted to NHS critical care units is to assess the risk of developing fungal infection and give preventative treatment, if needed, to patients who have been in the critical care unit for three days.  However, this finding is highly uncertain and future studies should consider the potential impact of increased resistance to antifungal drugs. 

Who led the study?

Dr David Harrison, ICNARC

The study was funded by the National Institute for Health Research (NIHR) – Health Technology Assessment (HTA) Programme (Project: 07/29/01)