The management of invasive fungal infections (IFI) in
immunosuppressive patients is a very important issue. Candida
spp. and Aspergillus spp. are the most frequent causes of
nosocomial IFIs. There are higher mortality rates in both of
them. Due to there are no specific symptoms of IFIs, evaluating
risk factors of those patients, taking appropriate samples
in suspected cases, early diagnosis and prompt initiation
of antifungal treatment are crucial behaviors for targeting
satisfactory outcomes. In this article, we review "The Infectious
Diseases Society of America (IDSA)", "The Infectious Diseases
Working Party (AGIHO) and The German Society Hematology
and Oncology (DGHO)", 'European Conference on Infections
in Leukemia’ (ECIL) and "The European Society for Clinical
Microbiology and Infectious Diseases (ESCMID)" guidelines
and expert opinions. The appropriate treatment needs to
be adjusted according to characteristics of patients and
health care centers. Caspofungin, micafungin, anidulafungin,
voriconazole or liposomal amphotericin B (LAmB) is the primary
agents recommended for the treatment of candidemia in nonneutropenic
patients according to specific criteria. Caspofungin,
micafungin, anidulafungin or LAmB is the convenient agents
for the management of neutropenic individuals, as well.
Voriconazole is recommended for the treatment of invasive
aspergillosis (IA). Besides posaconazole, LAmB or caspofungin
is the antifungal agents for salvage treatment of IA. Empirical
therapy for suspected candidemia in non-neutropenic patients,
fluconazole, caspofungin, anidulafungin or micafungin is proper.
Empirical therapy with an LFAmB, voriconazole, micafungin or
caspofungin is recommended for suspected IA in neutropenic
patients. As prophylaxis, fluconazole, posaconazole,
voriconazole or echinocandins can be used for patients at risk of
candidiasis according to the risk factors. According to primary
disease posaconazole, voriconazole, itraconazole, micafungin
or caspofungin is suggested as prophylaxis for IA. The goal of
this review is to remind the main approaches for treatment of
Candida and Aspergillus infections and to help determine a
road map by searching current guidelines.
Konular | Sağlık Kurumları Yönetimi |
---|---|
Bölüm | Derlemeler |
Yazarlar | |
Yayımlanma Tarihi | 16 Ekim 2017 |
Kabul Tarihi | 23 Haziran 2016 |
Yayımlandığı Sayı | Yıl 2017 Cilt: 18 Sayı: 4 |