Management of Candida species infections in critically ill patients

Details

Serval ID
serval:BIB_FE4B8BF88A77
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
Management of Candida species infections in critically ill patients
Journal
Lancet Infectious Diseases
Author(s)
Eggimann  P., Garbino  J., Pittet  D.
ISSN
1473-3099 (Print)
Publication state
Published
Issued date
12/2003
Volume
3
Number
12
Pages
772-85
Notes
Journal Article
Review --- Old month value: Dec
Abstract
Invasive candidiasis is a feared infection with mortality similar to that of septic shock (40-60%). Improved knowledge of its pathophysiology and the availability of new compounds for antifungal therapy and prophylaxis have contributed to improving the prognosis of severe candidal infections among immunosuppressed patients at the possible cost of the emergence of non-albicans strains of candida with lower susceptibility to azoles. This review focuses on the management of invasive deep-seated candidiasis in critically ill, non-immunocompromised patients. We discuss antifungal use, indications, potential benefit, and main secondary effects. Prevention strategies include pre-emptive antifungal therapy and azole-based prophylaxis. For patients at lower initial risk, pre-emptive therapy should be based on a management strategy that takes into account the presence of definite risk factors and the dynamics of candida colonisation. Among critically ill patients, azole prophylaxis is effective and is not associated with acquisition of resistance; it must be restricted to highly selected groups of patients at high risk only.
Keywords
Amphotericin B/therapeutic use Antifungal Agents/*therapeutic use Azoles/therapeutic use Candidiasis/*prevention & control Clinical Trials *Critical Illness Humans Immunocompetence Nystatin/therapeutic use Practice Guidelines
Pubmed
Web of science
Create date
24/01/2008 17:57
Last modification date
20/08/2019 17:28
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