Figure 1.

Flow diagram showing initial treatment choices and drug class switching for adult patients with candidemia detected through the Emerging Infections Program surveillance system at 9 US surveillance sites during 2017–2018. SD, standard deviation. ^aPatients who received an antifungal drug other than an echinocandin or fluconazole as initial treatment were excluded from further analyses. Other antifungal drugs received as initial treatment included amphotericin (n = 18), azoles other than fluconazole (n = 14), and other antifungal drugs (n = 2). ^bReasons for not receiving an antifungal drug included death (n = 154) or discharge (n = 77) before the culture result was available to the clinician, the initiation of comfort care-only measures (n = 66), clinician interpretation that the culture was clinically insignificant (n = 20), refusal of treatment against medical advice (n = 14), and unknown reason (n = 105).