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Published in: Advances in Therapy 12/2019

Open Access 01-12-2019 | Amphotericin B | Review

Choosing the Right Antifungal Agent in ICU Patients

Authors: Jeanne Chatelon, Andrea Cortegiani, Emmanuelle Hammad, Nadim Cassir, Marc Leone

Published in: Advances in Therapy | Issue 12/2019

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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.
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Metadata
Title
Choosing the Right Antifungal Agent in ICU Patients
Authors
Jeanne Chatelon
Andrea Cortegiani
Emmanuelle Hammad
Nadim Cassir
Marc Leone
Publication date
01-12-2019
Publisher
Springer Healthcare
Published in
Advances in Therapy / Issue 12/2019
Print ISSN: 0741-238X
Electronic ISSN: 1865-8652
DOI
https://doi.org/10.1007/s12325-019-01115-0

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