Treatment options of invasive fungal infections in adults
| Autor: | Martin G. Täuber, Jorge Garbino, Michel P. Glauser, Jacques Bille, Oscar Marchetti, Ursula Flückiger, Alexander Imhof, Philippe Eggimann, Christian Ruef, Stefan Zimmerli, Didier Pittet, Thierry Calandra |
|---|---|
| Rok vydání: | 2006 |
| Předmět: |
Azoles
medicine.medical_specialty Antifungal Agents Combination therapy Polyenes/therapeutic use Salvage therapy Polyenes Candidiasis/ drug therapy/epidemiology Aspergillosis Peptides Cyclic Fungal Proteins Echinocandins chemistry.chemical_compound Switzerland/epidemiology Pharmacotherapy Aspergillosis/ drug therapy/epidemiology Fungal Proteins/therapeutic use Peptides Cyclic/therapeutic use Amphotericin B deoxycholate medicine Humans Intensive care medicine ddc:616 Voriconazole Clinical Trials as Topic business.industry Candidiasis General Medicine bacterial infections and mycoses medicine.disease chemistry Drug Therapy Combination Azoles/therapeutic use Antifungal Agents/adverse effects/ therapeutic use Caspofungin business Switzerland Fluconazole medicine.drug |
| Zdroj: | Swiss Medical Weekly, Vol. 136, No 29-30 (2006) pp. 447-463 |
| ISSN: | 1424-3997 1424-7860 |
| DOI: | 10.4414/smw.2006.11392 |
| Popis: | A panel of infectious disease specialists, clinical microbiologists and hospital epidemiologists of the five Swiss university hospitals reviewed the current literature on the treatment of invasive fungal infections in adults and formulated guidelines for the management of patients in Switzerland. For empirical therapy of Candida bloodstream infection, fluconazole is the drug of choice in non-neutropenic patients with no severe sepsis or septic shock or recent exposure to azoles. Amphotericin B deoxycholate or caspofungin would be the treatment option for patients with previous azole exposure. In neutropenic patients, empirical therapy with amphotericin B deoxycholate is considered first choice. In patients with severe sepsis and septic shock, caspofungin is the drug of first choice. For therapy of microbiologically-documented Candida infection, fluconazole is the drug of choice for infections due to C. albicans, C. tropicalis or C. parapsilosis. When infections are caused by C. glabrata or by C. krusei, caspofungin or amphotericin B deoxycholate are first line therapies. Treatment guidelines for invasive aspergillosis (IA) were stratified into primary therapy, salvage therapy and combination therapy in critically ill patients. Voriconazole is recommended for primary (ie upfront) therapy. Caspofungin, voriconazole (if not used for primary therapy) or liposomal amphotericin B are recommended for salvage therapy for refractory disease. Combination therapy with caspofungin plus voriconazole or liposomal amphotericin B should be considered in critically ill patients. Amphotericin B deoxycholate is recommended as initial therapy for the empirical therapy in patients with neutropenia and persistent fever with close monitoring of adverse events. |
| Databáze: | OpenAIRE |
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