Management of invasive candidiasis and candidemia in adult non-neutropenic intensive care unit patients: Part II. Treatment.

Abstract:

BACKGROUND:Invasive candidiasis and candidemia are frequently encountered in the nosocomial setting particularly in the intensive care unit (ICU). OBJECTIVE AND METHODS:To review the current management of invasive candidiasis and candidemia in non-neutropenic adult ICU patients based on a review of the literature and an European expert panel discussion. RESULTS AND CONCLUSIONS:Empiric and directed treatment for invasive candidiasis are predicated on the hemodynamic status of the patient. Unstable patients may benefit from broad-spectrum antifungal agents, which can be narrowed once the patient has stabilized and the identity of the infecting species is established. In stable patients, a more classical approach using fluconazole may be satisfactory provided that the patient is not colonized with fluconazole resistant strains or there has been recent past exposure to an azole (<30 days). In contrast, pre-emptive therapy is based on the presence of surrogate markers.

journal_name

Intensive Care Med

journal_title

Intensive care medicine

authors

Guery BP,Arendrup MC,Auzinger G,Azoulay E,Borges Sá M,Johnson EM,Müller E,Putensen C,Rotstein C,Sganga G,Venditti M,Zaragoza Crespo R,Kullberg BJ

doi

10.1007/s00134-008-1339-6

subject

Has Abstract

pub_date

2009-02-01 00:00:00

pages

206-14

issue

2

eissn

0342-4642

issn

1432-1238

journal_volume

35

pub_type

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