Treatment options of invasive fungal infections in adults.

Détails

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Etat: Public
Version: Final published version
ID Serval
serval:BIB_B671A5617F0E
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
Treatment options of invasive fungal infections in adults.
Périodique
Swiss medical weekly
Auteur(s)
Flückiger U., Marchetti O., Bille J., Eggimann P., Zimmerli S., Imhof A., Garbino J., Ruef C., Pittet D., Täuber M., Glauser M., Calandra T.
Collaborateur(s)
Fungal Infection Network of Switzerland (FUNGINOS)
ISSN
1424-7860 (Print)
ISSN-L
0036-7672
Statut éditorial
Publié
Date de publication
22/07/2006
Peer-reviewed
Oui
Volume
136
Numéro
29-30
Pages
447-463
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't ; Review
Publication Status: ppublish
Résumé
A panel of infectious disease specialists, clinical microbiologists and hospital epidemiologists of the five Swiss university hospitals reviewed the current literature on the treatment of invasive fungal infections in adults and formulated guidelines for the management of patients in Switzerland. For empirical therapy of Candida bloodstream infection, fluconazole is the drug of choice in non-neutropenic patients with no severe sepsis or septic shock or recent exposure to azoles. Amphotericin B deoxycholate or caspofungin would be the treatment option for patients with previous azole exposure. In neutropenic patients, empirical therapy with amphotericin B deoxycholate is considered first choice. In patients with severe sepsis and septic shock, caspofungin is the drug of first choice. For therapy of microbiologically-documented Candida infection, fluconazole is the drug of choice for infections due to C. albicans, C. tropicalis or C. parapsilosis. When infections are caused by C. glabrata or by C. krusei, caspofungin or amphotericin B deoxycholate are first line therapies. Treatment guidelines for invasive aspergillosis (IA) were stratified into primary therapy, salvage therapy and combination therapy in critically ill patients. Voriconazole is recommended for primary (ie upfront) therapy. Caspofungin, voriconazole (if not used for primary therapy) or liposomal amphotericin B are recommended for salvage therapy for refractory disease. Combination therapy with caspofungin plus voriconazole or liposomal amphotericin B should be considered in critically ill patients. Amphotericin B deoxycholate is recommended as initial therapy for the empirical therapy in patients with neutropenia and persistent fever with close monitoring of adverse events.

Mots-clé
Antifungal Agents/adverse effects, Antifungal Agents/therapeutic use, Aspergillosis/drug therapy, Aspergillosis/epidemiology, Azoles/therapeutic use, Candidiasis/drug therapy, Candidiasis/epidemiology, Clinical Trials as Topic, Drug Therapy, Combination, Echinocandins, Fungal Proteins/therapeutic use, Humans, Peptides, Cyclic/therapeutic use, Polyenes/therapeutic use, Switzerland/epidemiology
Pubmed
Web of science
Création de la notice
25/01/2008 14:33
Dernière modification de la notice
20/08/2019 16:24
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