Author/Authors
karacaer, zehra gülhane eğitim ve araştırma hastanesi - infeksiyon hastalıkları ve klinik mikrobiyoloji, turkey , karaahmetoğlu, gökhan bursa ilker çelikcan fizik tedavi ve rehabilitasyon hastanesi - infeksiyon hastalıkları ve klinik mikrobiyoloji, turkey
Title Of Article
TREATMENT OF NOSOCOMIAL CANDIDEMIA AND INVASIVE ASPERGILLOSIS: CURRENT APPROACHES
شماره ركورد
42305
Abstract
The management of invasive fungal infections (IFI) inimmunosuppressive patients is a very important issue. Candidaspp. and Aspergillus spp. are the most frequent causes ofnosocomial IFIs. There are higher mortality rates in both ofthem. Due to there are no specific symptoms of IFIs, evaluatingrisk factors of those patients, taking appropriate samplesin suspected cases, early diagnosis and prompt initiationof antifungal treatment are crucial behaviors for targetingsatisfactory outcomes. In this article, we review The InfectiousDiseases Society of America (IDSA), The Infectious DiseasesWorking Party (AGIHO) and The German Society Hematologyand Oncology (DGHO), European Conference on Infectionsin Leukemia’ (ECIL) and The European Society for ClinicalMicrobiology and Infectious Diseases (ESCMID) guidelinesand expert opinions. The appropriate treatment needs tobe adjusted according to characteristics of patients andhealth care centers. Caspofungin, micafungin, anidulafungin,voriconazole or liposomal amphotericin B (LAmB) is the primaryagents recommended for the treatment of candidemia in nonneutropenicpatients according to specific criteria. Caspofungin,micafungin, anidulafungin or LAmB is the convenient agentsfor the management of neutropenic individuals, as well.Voriconazole is recommended for the treatment of invasiveaspergillosis (IA). Besides posaconazole, LAmB or caspofunginis the antifungal agents for salvage treatment of IA. Empiricaltherapy for suspected candidemia in non-neutropenic patients,fluconazole, caspofungin, anidulafungin or micafungin is proper.Empirical therapy with an LFAmB, voriconazole, micafungin orcaspofungin is recommended for suspected IA in neutropenicpatients. As prophylaxis, fluconazole, posaconazole,voriconazole or echinocandins can be used for patients at risk ofcandidiasis according to the risk factors. According to primarydisease posaconazole, voriconazole, itraconazole, micafunginor caspofungin is suggested as prophylaxis for IA. The goal ofthis review is to remind the main approaches for treatment ofCandida and Aspergillus infections and to help determine aroad map by searching current guidelines.
From Page
166
NaturalLanguageKeyword
Nosocomial Infection , Candidemia , Aspergillosis , Guidelines
JournalTitle
Kocatepe Medical Journal
To Page
174
JournalTitle
Kocatepe Medical Journal
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