Choosing the Right Antifungal Agent in ICU Patients.
Adv Ther
; 36(12): 3308-3320, 2019 12.
Article
de En
| MEDLINE
| ID: mdl-31617055
ABSTRACT
Fungi are responsible for around 20% of microbiologically documented infections in intensive care units (ICU). In the last decade, the incidence of invasive fungal infections (IFI), including candidemia, has increased steadily because of increased numbers of both immunocompromised and ICU patients. To improve the outcomes of patients with IFI, intensivists need to be aware of the inherent challenges. This narrative review summarizes the features of routinely used treatments directed against IFI in non-neutropenic ICU patients, which include three classes of antifungals polyenes, azoles, and echinocandins. ICU patients' pathophysiological changes are responsible for deep changes in the pharmacokinetics of antifungals. Moreover, drug interactions affect the response to antifungal treatments. Consequently, appropriate antifungal dosage is a challenge under these special conditions. Dosages should be based on renal and liver function, and serum concentrations should be monitored. This review summarizes recent guidelines, focusing on bedside management.
Mots clés
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Infections fongiques invasives
/
Unités de soins intensifs
/
Antifongiques
Type d'étude:
Guideline
/
Incidence_studies
/
Prognostic_studies
/
Systematic_reviews
Limites:
Humans
Langue:
En
Journal:
Adv Ther
Sujet du journal:
TERAPEUTICA
Année:
2019
Type de document:
Article
Pays d'affiliation:
France