Clinical trials of antifungal prophylaxis among patients undergoing surgery

Details

Ressource 1Download: serval:BIB_3DAF04C7A706.P001 (123.84 [Ko])
State: Public
Version: author
License: Not specified
It was possible to publish this article open access thanks to a Swiss National Licence with the publisher.
Serval ID
serval:BIB_3DAF04C7A706
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Clinical trials of antifungal prophylaxis among patients undergoing surgery
Journal
Clinical Infectious Diseases
Author(s)
Calandra  T., Marchetti  O.
ISSN
1537-6591 (Electronic)
Publication state
Published
Issued date
10/2004
Volume
39 Suppl 4
Pages
S185-92
Notes
Journal Article --- Old month value: Oct 15
Abstract
Invasive mycoses have emerged as a major cause of morbidity and mortality. Epidemiological studies have shown that surgery services have the highest rate of Candida infections in the hospital. In addition to classical risk factors, heavy Candida colonization, recurrent gastrointestinal perforations, and acute pancreatitis are frequently associated with invasive candidiasis. Because prompt initiation of antifungal therapy is critical for cure but difficult to accomplish, prevention of fungal infections may play an important role in this clinical setting; however, few prophylactic or preemptive studies have been done to date. The choice, route of administration, and dose of the antifungal and comparator regimens and the use of clinically relevant and robust study end points are critical for the trial design. Various criteria have been used to identify patients at risk of candidiasis: surgical condition, presence of multiple risk factors, colonization indexes, or expected length of stay in the intensive care unit. Some are not selective enough, and others are time consuming and expensive. Rigorous selection of high-risk patients is crucial to optimize the risk-benefit ratio of preventive antifungal strategies. The aim is to maximize chances of reducing morbidity and mortality while minimizing treatment costs, exposure of low-risk patients to adverse events, and emergence of resistant fungal strains.
Keywords
Antifungal Agents/*therapeutic use Candida Candidiasis/epidemiology/*prevention & control Clinical Trials Humans Postoperative Complications/*prevention & control *Preventive Medicine *Research Design Risk Factors *Surgery
Pubmed
Web of science
Open Access
Yes
Create date
25/01/2008 14:33
Last modification date
25/09/2019 7:09
Usage data