Treatment of invasive candidiasis in non-haematological patients

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Andes pooled data analysis1915 patients, two polyenes, two triazoles, three candinsLogistic regression using 30-day mortality as primary outcomeIncreased mortality• Age• APACHE II• Immunosuppressive therapy• C. tropicalisDecreased mortality• CVC removal during therapy• Echinocandin antifungal"These results support first-line treatment withan echinocandin to the majority of patients”Similar risk factors by subgroup: C. albicans, C. glabrata,all non-albicansAndes et al., Clin Infect Dis 2012
In conclusion• Invasive candidiasis still has a high mortality rate• Antifungal prophylaxis in ICU is effective butinappropriate• Empirical antifungal therapy in ICU is not proveneffective• Prediction rules to start pre-emptive therapy have ahign NPV, and a reasonable specificity. Especiallyuseful in high incidence areas/patients• Intravascular catheters should be removed/replacedwhenever feasible• Treatment with an echinocandin is preferred, for thehigher response rate
Page 5 and 6: EpidemiologyMainly data from the US
Page 7 and 8: Survival in candidemia, species rel
Page 9 and 10: Question1 : Which Candida species i
Page 11 and 12: Incidence and mortality of Candida
Page 13 and 14: HOW TO IDENTIFY PATIENTSAT RISK FOR
Page 15 and 16: Question 2: Which factor has the gr
Page 17 and 18: Identification of patients“Ostros
Page 19 and 20: Question3: What’s the problem wit
Page 21 and 22: Identification of patients“Ostros
Page 23 and 24: Are the risk predictive models gene
Page 25 and 26: Question 4: Empirical treatment is
Page 27 and 28: HOW TO PREVENT INVASIVECANDIDIASIS
Page 29 and 30: Empirical antifungal therapy in ICU
Page 31 and 32: TREATMENT OF INVASIVECANDIDIASIS
Page 33 and 34: Why do we choose whichantifungal dr
Page 35 and 36: Randomized Non-Inferior TrialsAmB v
Page 37 and 38: Caspofungin vs. Amphotericin B tria
Page 39 and 40: Micafungin vs. L-AmB in ICU Patient
Page 41 and 42: Anidulafungin vs. fluconazole study
Page 43 and 44: Success rates different echinocandi
Page 45 and 46: Question 5: Should the intravascula
Page 47: Antifungal agents and survivalCandi
Page 51 and 52: Treatment of candidemia-Candida spe
Page 53 and 54: Success at EIV treatment by pathoge
Page 55 and 56: Question 6: Should the intravascula
Page 57 and 58: Candida Scorein practiceProspective

Treatment of invasive candidiasis in non-haematological patients

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