Antifungal De-Escalation Is Safe in Critically Ill Patients Treated For Suspected Or Documented Invasive Candidiasis. Data From The Amarcand2 Study
نویسندگان
چکیده
Introduction Systemic Antifungal therapy (SAT) of invasive candidiasis (IC) needs to be started immediately upon clinical suspicion. Controversies exist then about potential harms from antifungal de-escalation (DE).(1) In cases of documented IC, early DE to fluconazole is recommended by US guidelines but discouraged in EU guidelines. In non-documented IC, no data are available to guide SAT DE. These questions are key issues however as the relationship between antifungal use and Candida antifungal resistance has been repeatedly demonstrated.
منابع مشابه
Micafungin versus anidulafungin in critically ill patients with invasive candidiasis: a retrospective study
BACKGROUND In critically ill patients the incidence of invasive fungal infections caused by Candida spp. has increased remarkably. Echinocandins are recommended as initial treatment for invasive fungal infections. The safety and efficacy of micafungin compared to caspofungin is similar, but no comparison is made between anidulafungin and micafungin concerning safety and efficacy. We therefore p...
متن کاملEvaluation of "Candida score" in critically ill patients: a prospective, multicenter, observational, cohort study
INTRODUCTION Although prompt initiation of appropriate antifungal therapy is essential for the control of invasive Candida infections and an improvement of prognosis, early diagnosis of invasive candidiasis remains a challenge and criteria for starting empirical antifungal therapy in ICU patients are poorly defined. Some scoring systems, such as the "Candida score" could help physicians to diff...
متن کاملSystemic antifungal therapy for proven or suspected invasive candidiasis: the AmarCAND 2 study
BACKGROUND In the context of recent guidelines on invasive candidiasis (IC), how French intensive care units (ICUs) are managing IC? METHODS This is a prospective observational multicenter cohort study. During 1 year (2012-2013), 87 French ICUs enrolled consecutive patients with suspected or proven IC (SIC or PIC) and receiving systemic antifungal therapy (SAT). Data were collected up to 28 d...
متن کامل[Épico project: Development of educational recommendations using the DELPHI technique on invasive candidiasis in non-neutropenic critically ill adult patients. Grupo Proyecto Épico].
BACKGROUND Although there has been an improved management of invasive candidiasis in the last decade, controversial issues still remain, especially in the diagnostic and therapeutic approaches. AIMS We sought to identify the core clinical knowledge and to achieve high level agreement recommendations required to care for critically ill adult patients with invasive candidiasis. METHODS A pros...
متن کاملMolecular identification and antifungal susceptibility of Candida albicans isolated from Vulvovaginitis Candidiasis
Vulvovaginal candidiasis is caused by the increasing number of Candida species as normal flora in the vagina. To assess the transmission rout as well as to determine the suitable antifungal drugs for treatment, the exact identification of Candida species is crucial. Therefore, earlier detection of infection allows quick initiation of antifungal therapy with a greater probability for improved su...
متن کامل