Invasive candidiasis and candidemia: new guidelines.

Abstract:

:Invasive candidiasis (IC) includes candidemia, disseminated candidiasis with deep organ involvement, endocarditis and meningitis. IC has an attributable mortality of 40% to 50% and is increasingly reported in intensive care units (ICUs). Candida albicans and non-albicans strains are both responsible for infections in ICUs, where empirical and targeted treatments especially need to be initially appropriate. This review synthesizes the most recent guidelines for IC and candidemia from an ICU perspective. Essentially, patients who have been previously exposed to azoles have a higher probability of being infected by azole-resistant or non-albicans strains. Infection site, illness severity, neutropenia, hemodynamic status, organ failure and concomitant drug treatments are host-related factors that influence the choice of anti-fungal treatment. In general, echinocandins are currently favored for empiric treatment of candidemia, especially in critically ill patients or those with previous azole exposure. Pharmacokinetic properties and side effects suggest that polyenes should be avoided in patients with renal failure, and that echinocandins and azoles should be avoided in patients with severe hepatic dysfunction.

journal_name

Minerva Anestesiol

journal_title

Minerva anestesiologica

authors

De Rosa FG,Garazzino S,Pasero D,Di Perri G,Ranieri VM

subject

Has Abstract

pub_date

2009-07-01 00:00:00

pages

453-8

issue

7-8

eissn

0375-9393

issn

1827-1596

pii

R02085421

journal_volume

75

pub_type

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