Antifungals in the ICU

Playford, Elliott Geoffrey, Eggimann, Philippe and Calandra, Thierry (2008) Antifungals in the ICU. Current Opinion in Infectious Diseases, 21 6: 610-619. doi:10.1097/QCO.0b013e3283177967


Author Playford, Elliott Geoffrey
Eggimann, Philippe
Calandra, Thierry
Title Antifungals in the ICU
Journal name Current Opinion in Infectious Diseases   Check publisher's open access policy
ISSN 0951-7375
1473-6527
Publication date 2008-12
Sub-type Article (original research)
DOI 10.1097/QCO.0b013e3283177967
Volume 21
Issue 6
Start page 610
End page 619
Total pages 10
Place of publication Philadelphia, PA, United States
Publisher Lippincott Williams & Wilkins
Language eng
Subject 11 Medical and Health Sciences
1103 Clinical Sciences
Formatted abstract
AB Purpose of review:
Invasive fungal infections remain a serious complication for critically ill ICU patients. The aim of this article is to review recent efficacy data of newer antifungal agents for the treatment of invasive candidiasis. The influence that recent epidemiological trends, advances in diagnostic testing, and risk prediction methods exert on the optimization of antifungal therapy for critically ill ICU patients will also be reviewed.

Recent findings:
Recent clinical trials have documented the clinical efficacy of the echinocandins and the newer triazoles for the management of invasive candidiasis. Thus far, resistance to echinocandins remains rare. Changes in the epidemiology of Candida spp. causing invasive candidiasis, such as an increasing relative proportion of non-albicans Candida spp., have not been universally reported, although they have important implications for the use of fluconazole as first-line therapy for invasive candidiasis. Efforts to improve the timeliness and accuracy of laboratory diagnostic techniques and clinical prediction models to allow early and accurately targeted antifungal intervention strategies continue.

Summary:

Echinocandins, given their clinical efficacy, spectrum of activity, and favourable pharmacological properties, are likely to replace fluconazole as initial antifungal agents of choice among critically ill ICU patients. The optimization of patient outcomes will require more accurately targeted early antifungal intervention strategies based upon sensitive and specific biological and clinical markers of risk.
Keyword Fungal infections
ICU patients
Antifungal Agents
Echinocandins
Candidiasis
Fluconazole
Laboratory diagnostic techniques
Clinical prediction models
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Excellence in Research Australia (ERA) - Collection
School of Medicine Publications
 
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Created: Wed, 06 Jan 2010, 14:29:25 EST by Ms May Balasaize on behalf of Faculty Of Health Sciences