Clinical trials of antifungal prophylaxis among patients undergoing surgery

Détails

Ressource 1Télécharger: serval:BIB_3DAF04C7A706.P001 (123.84 [Ko])
Etat: Public
Version: de l'auteur
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ID Serval
serval:BIB_3DAF04C7A706
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Synthèse (review): revue aussi complète que possible des connaissances sur un sujet, rédigée à partir de l'analyse exhaustive des travaux publiés.
Collection
Publications
Institution
Titre
Clinical trials of antifungal prophylaxis among patients undergoing surgery
Périodique
Clinical Infectious Diseases
Auteur(s)
Calandra  T., Marchetti  O.
ISSN
1537-6591 (Electronic)
Statut éditorial
Publié
Date de publication
10/2004
Volume
39 Suppl 4
Pages
S185-92
Notes
Journal Article --- Old month value: Oct 15
Résumé
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.
Mots-clé
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
Oui
Création de la notice
25/01/2008 14:33
Dernière modification de la notice
25/09/2019 7:09
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