Treatment options of invasive fungal infections in adults.

Details

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State: Public
Version: Final published version
Serval ID
serval:BIB_B671A5617F0E
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
Treatment options of invasive fungal infections in adults.
Journal
Swiss medical weekly
Author(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.
Working group(s)
Fungal Infection Network of Switzerland (FUNGINOS)
ISSN
1424-7860 (Print)
ISSN-L
0036-7672
Publication state
Published
Issued date
22/07/2006
Peer-reviewed
Oui
Volume
136
Number
29-30
Pages
447-463
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't ; Review
Publication Status: ppublish
Abstract
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.

Keywords
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
Create date
25/01/2008 14:33
Last modification date
20/08/2019 16:24
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