Antifungals in the ICU.

Details

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State: Public
Version: Final published version
Serval ID
serval:BIB_4A3D9E46123F
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
Antifungals in the ICU.
Journal
Current Opinion in Infectious Diseases
Author(s)
Playford E.G., Eggimann P., Calandra T.
ISSN
0951-7375
Publication state
Published
Issued date
2008
Peer-reviewed
Oui
Volume
21
Number
6
Pages
610-9
Language
english
Notes
Publication types: Journal Article ; Review
Abstract
PURPOSE OF REVIEW: Invasive fungal infections remain a serious complication for critically ill ICU patients. The aim of this article is to review recent efficacy data of newer antifungal agents for the treatment of invasive candidiasis. The influence that recent epidemiological trends, advances in diagnostic testing, and risk prediction methods exert on the optimization of antifungal therapy for critically ill ICU patients will also be reviewed. RECENT FINDINGS: Recent clinical trials have documented the clinical efficacy of the echinocandins and the newer triazoles for the management of invasive candidiasis. Thus far, resistance to echinocandins remains rare. Changes in the epidemiology of Candida spp. causing invasive candidiasis, such as an increasing relative proportion of non-albicans Candida spp., have not been universally reported, although they have important implications for the use of fluconazole as first-line therapy for invasive candidiasis. Efforts to improve the timeliness and accuracy of laboratory diagnostic techniques and clinical prediction models to allow early and accurately targeted antifungal intervention strategies continue. SUMMARY: Echinocandins, given their clinical efficacy, spectrum of activity, and favourable pharmacological properties, are likely to replace fluconazole as initial antifungal agents of choice among critically ill ICU patients. The optimization of patient outcomes will require more accurately targeted early antifungal intervention strategies based upon sensitive and specific biological and clinical markers of risk.
Keywords
Antifungal Agents, Candida, Candidiasis, Critical Illness, Echinocandins, Fluconazole, Humans, Intensive Care Units, Triazoles
Pubmed
Web of science
Create date
19/03/2009 18:05
Last modification date
20/08/2019 14:57
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