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


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2008-10-30

AUTHORS

Benoît P. Guery, Maiken C. Arendrup, Georg Auzinger, Élie Azoulay, Márcio Borges Sá, Elizabeth M. Johnson, Eckhard Müller, Christian Putensen, Coleman Rotstein, Gabriele Sganga, Mario Venditti, Rafael Zaragoza Crespo, Bart Jan Kullberg

ABSTRACT

BackgroundInvasive candidiasis and candidemia are frequently encountered in the nosocomial setting particularly in the intensive care unit (ICU).Objective and methodsTo 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 conclusionsEmpiric 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. More... »

PAGES

206

Journal

TITLE

Intensive Care Medicine

ISSUE

2

VOLUME

35

Author Affiliations

  • Infectious Diseases, SGRIVI, Hopital Huriez, CHRU Lille, 59045, Lille Cedex, France
  • Unit of Mycology, Department Bacteriology, Mycology and Parasitology, Statens Serum Institut, Building 43/117, 2300, Copenhagen, Denmark
  • Liver Intensive Care, Institute of Liver Studies, King’s College Hospital, Denmark Hill, SE5 9RS, London, UK
  • Service de Réanimation Médicale, Hôpital Saint-Louis, 1, avenue Claude-Bellefaux, 75010, Paris, France
  • Sepsis Unit, Intensive Care Department, Hospital Son Llàtzer, Palma de Mallorca, Spain
  • Mycology Reference Laboratory, National Collection of Pathogenic Fungi, The HPA Centre for Infections, HPA South West Laboratory, Myrtle Road, Kingsdown, BS2 8EL, Bristol, UK
  • Universitätsklinik für Anästhesiologie, Intensivmedizin und Schmerztherapie, Knappschaftskrankenhaus Bochum, Langendreer, Klinikum der Ruhr-Universität, In der Schornau 23–25, 44892, Bochum, Germany
  • Operative Intensivmedizin, Klinik und Poliklinik für Anästhesiologie und Operative Intensivmedizin, Rheinische-Friedrich-Wilhelms Universität Bonn, Sigmund-Freud Str. 25, 53127, Bonn, Germany
  • Division of Infectious Diseases, University Health Network, Toronto General Hospital, NCSB 11-1212, 200 Elizabeth Street, M5G 2C4, Toronto, ON, Canada
  • Department of Surgery, Division of General Surgery and Organ Transplantation, Policlinico ‘A Gemelli’, Catholic University, Largo Gemelli, 8, 00168, Rome, Italy
  • Internal Medicine, Clinical Medicine Department, “La Sapienza” University, Rome, Viale dell’ Università, 37, 00185, Rome, Italy
  • Secretario GTEI-SEMICYUC, Medicina Intensiva, Hospital Universitario Dr. Peset, Avenida Gaspa Aguilar, 90, 46107, Valencia, Spain
  • Department of Medicine (463), Nijmegen Institute for Infection, Inflammation, and Immunity (N4i), Radboud University Nijmegen Medical Centre, PO Box 9101, 6500 HB, Nijmegen, The Netherlands
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s00134-008-1339-6

    DOI

    http://dx.doi.org/10.1007/s00134-008-1339-6

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1053260834

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/18972100


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    20 schema:description BackgroundInvasive candidiasis and candidemia are frequently encountered in the nosocomial setting particularly in the intensive care unit (ICU).Objective and methodsTo 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 conclusionsEmpiric 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.
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