Current strategies for treating invasive candidiasis: emphasis on infections in nonneutropenic patients.
Current strategies for treating invasive candidiasis: emphasis on infections in nonneutropenic patients.
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当前治疗侵袭性念珠菌病的策略：强调非中性粒细胞减少症患者的感染。
DOI：
10.1093/clinids/14.supplement_1.s106
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发表时间：
1992
期刊：
影响因子：
--
通讯作者：
Filler,SG
中科院分区：
文献类型：
--
作者：
EdwardsJr,JE;Filler,SG
医院内念珠菌感染的发生率增加是没有中性粒细胞减少症的患者的关键问题。与以前的原则相反，念珠菌病，即使在非血小板减少症的患者，除了在罕见的情况下，应该用全身抗真菌药物治疗。两性霉素B仍然是治疗血源性播散性念珠菌病和念珠菌血症的首选药物，尽管这种治疗的最佳剂量和持续时间尚不明确。氟康唑治疗是对阿替霉素B不耐受的患者的一种替代疗法;氟康唑与阿替霉素B相比治疗血源性念珠菌感染的疗效尚不清楚，但目前正在进行评估。在几乎所有的情况下，去除被感染的假体装置是治愈感染所必需的。同样，与在抗真菌治疗期间将导管留在原位相比，移除使用与念珠菌血症相关的留置导管可能会增加患者的存活率并降低并发症的发生率。抗真菌预防可能对正在接受器官移植的患者有用。
The increasing incidence of nosocomial candidal infections is a pivotal problem for patients who do not have neutropenia. In contrast with previous principles, candidemia—even in nonneutropenic patients—should be treated with systemic antifungal agents except in rare circumstances. Amphotericin B remains the agent of choice for treatment of hematogenously disseminated candidiasis and for candidemia, although the optimal dosage and duration of this therapy are poorly defined. Therapy with fluconazole is an alternative for patients who are intolerant to amphotericin B; the efficacy of fluconazole compared with that of amphotericin B in hematogenous candidal infections is unknown but is currently being evaluated. Removal of prosthetic devices that are infected withCandidais necessary in nearly all instances to cure the infection. Similarly, removal of an indwelling catheter whose use is associated with candidemia, as opposed to leaving the catheter in place during antifungal therapy, may increase survival rates of patients and lower their rates of complication. Antifungal prophylaxis may be useful for patients who are undergoing transplantation of an organ.