Treatment of fungal infections in surgical patients using conventional antifungals.
In surgical and intensive care units an alarming increase in the number of invasive fungal infections has been observed. This is partly due to temporal transferral of patients from hemato-oncological units or transplant units and partly to the enhanced use of corticosteroids and other immunosuppressants. Candida species have now become a common isolate in ill patients. Amphotericin B with or without flucytosine constituted the standard therapy for candidosis but similar response rates with less toxicity may be obtained with lipid and with fluconazole. Data on an improved outcome of candidemia if a central venous catheter is removed promptly are conflicting. Amphotericin B remains the standard therapy for other invasive mycoses; it is seldom possible to administer adequate doses and therefore the options and limitations of the triazoles and liposomal preparations should be explored.
De Pauw
B E
BE
Department of Bloodtransfusion, University Hospital Nijmegen, The Netherlands. b.depauw@hemat.azn.nl
Donnelly
J P
JP
Kullberg
B J
BJ
D000935:Antifungal Agents / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D002175:Candida / Q000302:isolation & purification / Q000472:pathogenicity; D002177:Candidiasis / Q000188:drug therapy / Q000473:pathology; D006801:Humans; D016867:Immunocompromised Host; D007362:Intensive Care Units; D009181:Mycoses / Q000188:drug therapy* / Q000473:pathology; D013530:Surgical Wound Infection / Q000188:drug therapy / Q000382:microbiology* / Q000473:pathology
D000935:Antifungal Agents