[Indication for antimycotic therapy for tracheobronchial candidosis under artificial ventilation].
Tracheobronchial candidosis is an impetuous complication in intensive care medicine. This article presents a concept to compare diagnostic procedure, Candida species and resistant species of different intensive care units with each other. This concept should encourage bench marking between similar intensive care units. The report and retrospective analysis of the intensive care course offer the opportunity to reflect own decisions and to adjust them to the current therapy strategies. Both procedures should improve the antimycotic therapy for intensive care units and should avoid the occurrence of resistant species. Candida species are often detected in the respiratory system of ventilated patients in intensive care, but this alone is no indication for antimycotic therapy. A strict retention is recommended, but this retention is diminished by an unclear infection, critical situation of the patient in the case of multiple organ failure, additional infection and long term ventilation. A therapy strategy for individual situations should be established and a close diagnostic procedure should be performed. A positive blood culture or detection of Candida species in two or more diagnostic materials indicate an early antimycotic therapy.
Grossherr
M
M
Klinik für Anästhesiologie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, D-23538 Lübeck, Germany. grossher@medinf.mu-luebeck.de
Sedemund-Adib
Beate
B
Klotz
K-F
KF
D000935:Antifungal Agents / Q000627:therapeutic use; D001982:Bronchial Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D002175:Candida / Q000302:isolation & purification; D002177:Candidiasis / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D006801:Humans; D007362:Intensive Care Units; D012121:Respiration, Artificial; D014133:Tracheal Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D012122:Ventilators, Mechanical
D000935:Antifungal Agents