CAMEO—a cross-sectional survey study on candidemia management in Germany
Abstract
Abstract Candida species cause life-threatening bloodstream infections, particularly in critically ill and immunocompromised patients. Although guideline adherence has been shown to improve outcomes, real-world implementation is often constrained. This cross-sectional, web-based survey evaluated current clinical practices and barriers in candidemia management across German healthcare institutions. A structured questionnaire based on the EQUAL Candida score was disseminated online from 10/2023 to 07/2025. Physicians involved in candidemia management reported institutional characteristics, diagnostic practices, antifungal treatment strategies, central line management, and follow-up practices. Data were analyzed using descriptive statistics and chi-square testing. A total of 217 physicians from 147 institutions participated, with 74.5% of participants affiliated with large care facilities. Caspofungin was the predominant first-line therapy (81.4%), whereas fluconazole was used by 5.3% of participants. First-line choice did not differ by years of clinical experience (P = 0.194). Echocardiography was routinely performed by 57% of participants; selective use showed no association with years of clinical experience (P = 0.845) or annual number of candidemia cases (P = 0.089). Ophthalmoscopy was performed routinely by 37% of participants and showed no association with experience (P = 0.907), but was significantly associated with lower annual caseload (P = 0.02) and infectious disease…
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