2004-01-15 | Peter G. Pappas, John H. Rex, Jack D. Sobel, Scott G. Filler, William E. Dismukes, Thomas J. Walsh, and John E. Edwards
The guidelines for the treatment of candidiasis provide recommendations for managing various forms of fungal infections caused by Candida species. These guidelines are developed by the Infectious Diseases Society of America (IDSA) and are based on current scientific evidence. The guidelines cover four major areas: the role of the microbiology laboratory, treatment of invasive candidiasis, treatment of mucocutaneous candidiasis, and prevention of invasive candidiasis.
The microbiology laboratory plays a crucial role in guiding treatment, as susceptibility testing can now help determine the most effective antifungal therapy. However, this testing is not always available or routinely performed. Knowledge of the infecting species is essential for selecting the appropriate treatment, especially for infections caused by non-albicans species of Candida.
For invasive candidiasis, treatment options include amphotericin B-based preparations, azole antifungal agents, and echinocandin antifungal agents. The choice of therapy depends on the patient's condition, the species of Candida, and the availability of formulations. Amphotericin B is effective against many Candida species, but resistance can occur. Echinocandins like caspofungin are effective against some non-albicans species, including Candida krusei.
Mucocutaneous candidiasis is typically treated with azole antifungal agents, which can be used topically or systemically. However, some patients may experience relapses, and the cause may be difficult to determine. Treatment should consider the possibility of resistance with prolonged or repeated exposure.
Prevention of invasive candidiasis is recommended for high-risk patient groups, such as those undergoing prolonged neutropenia or solid-organ transplants. Prophylactic strategies are useful when the risk of a target disease is sharply elevated in a readily identified patient group.
The guidelines also discuss the use of available antifungal drugs, including voriconazole, caspofungin, and other newer agents. These drugs have shown activity against Candida species, but their clinical data are limited. The guidelines emphasize the importance of susceptibility testing and the need to consider the pharmacological properties of the drugs when selecting therapy.
The guidelines provide specific recommendations for the treatment of candidemia and acute hematogenously disseminated candidiasis, including the use of amphotericin B, fluconazole, and caspofungin. The choice of therapy depends on the patient's condition, the species of Candida, and the availability of formulations. The guidelines also emphasize the importance of removing central venous catheters in certain cases and the need for careful monitoring of patients with candidemia.
The guidelines also address the empirical treatment of suspected disseminated candidiasis in febrile nonneutropenic patients and the treatment of neutropenic patients with prolonged fever despite antibacterial therapy. These recommendations emphasize the importance of early antifungal therapy to prevent the development of invasive fungal infections.The guidelines for the treatment of candidiasis provide recommendations for managing various forms of fungal infections caused by Candida species. These guidelines are developed by the Infectious Diseases Society of America (IDSA) and are based on current scientific evidence. The guidelines cover four major areas: the role of the microbiology laboratory, treatment of invasive candidiasis, treatment of mucocutaneous candidiasis, and prevention of invasive candidiasis.
The microbiology laboratory plays a crucial role in guiding treatment, as susceptibility testing can now help determine the most effective antifungal therapy. However, this testing is not always available or routinely performed. Knowledge of the infecting species is essential for selecting the appropriate treatment, especially for infections caused by non-albicans species of Candida.
For invasive candidiasis, treatment options include amphotericin B-based preparations, azole antifungal agents, and echinocandin antifungal agents. The choice of therapy depends on the patient's condition, the species of Candida, and the availability of formulations. Amphotericin B is effective against many Candida species, but resistance can occur. Echinocandins like caspofungin are effective against some non-albicans species, including Candida krusei.
Mucocutaneous candidiasis is typically treated with azole antifungal agents, which can be used topically or systemically. However, some patients may experience relapses, and the cause may be difficult to determine. Treatment should consider the possibility of resistance with prolonged or repeated exposure.
Prevention of invasive candidiasis is recommended for high-risk patient groups, such as those undergoing prolonged neutropenia or solid-organ transplants. Prophylactic strategies are useful when the risk of a target disease is sharply elevated in a readily identified patient group.
The guidelines also discuss the use of available antifungal drugs, including voriconazole, caspofungin, and other newer agents. These drugs have shown activity against Candida species, but their clinical data are limited. The guidelines emphasize the importance of susceptibility testing and the need to consider the pharmacological properties of the drugs when selecting therapy.
The guidelines provide specific recommendations for the treatment of candidemia and acute hematogenously disseminated candidiasis, including the use of amphotericin B, fluconazole, and caspofungin. The choice of therapy depends on the patient's condition, the species of Candida, and the availability of formulations. The guidelines also emphasize the importance of removing central venous catheters in certain cases and the need for careful monitoring of patients with candidemia.
The guidelines also address the empirical treatment of suspected disseminated candidiasis in febrile nonneutropenic patients and the treatment of neutropenic patients with prolonged fever despite antibacterial therapy. These recommendations emphasize the importance of early antifungal therapy to prevent the development of invasive fungal infections.