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22.07.2017 | Current Management of Fungal Infections (M Miceli, Section Editor)

Untargeted Antifungal Treatment Strategies for Invasive Candidiasis in Non-neutropenic Critically Ill Patients: Current Evidence and Insights

verfasst von: Andrea Cortegiani, Vincenzo Russotto, Santi Maurizio Raineri, Cesare Gregoretti, Francesco Giuseppe De Rosa, Antonino Giarratano

Erschienen in: Current Fungal Infection Reports | Ausgabe 3/2017

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Abstract

Purpose of Review

The purpose of this study was to provide an overview and insights on important new concepts on untargeted antifungal treatment strategies, namely prophylaxis pre-emptive and empiric treatments for the management of invasive candidiasis (IC) in non-neutropenic critically ill patients.

Recent Findings

Recently, clinical practice guidelines provided recommendation for the management of IC. However, results from recent trials and systematic reviews questioned the effect of untargeted antifungal treatment strategies, especially in terms of survival benefits in non-neutropenic patients, even with septic shock.

Summary

Widespread use of untargeted antifungal treatment strategies seems not to be justified anymore. Future research should evaluate comprehensive diagnostic-therapeutic approaches, including the implementation of de-escalation. In the meanwhile, clinicians should take into account all available sources of information including clinical evaluation, risk factor assessment, scores, and surrogate biomarkers to tailor antifungal treatment before definitive microbiological diagnosis.

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Titel: Untargeted Antifungal Treatment Strategies for Invasive Candidiasis in Non-neutropenic Critically Ill Patients: Current Evidence and Insights
verfasst von: Andrea Cortegiani
Vincenzo Russotto
Santi Maurizio Raineri
Cesare Gregoretti
Francesco Giuseppe De Rosa
Antonino Giarratano
Publikationsdatum: 22.07.2017
Verlag: Springer US
Erschienen in: Current Fungal Infection Reports / Ausgabe 3/2017
Print ISSN: 1936-3761
Elektronische ISSN: 1936-377X
DOI: https://doi.org/10.1007/s12281-017-0288-3

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Abstract

Purpose of Review

Recent Findings

Summary

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