title: Current status of diagnosis and treatment of invasive fungal infections in Japan: the influence of the new Japanese guidelines.
abstract: One year after the release of the Japanese "Guidelines for the Diagnosis and Treatment of Deep-Seated Mycosis" we conducted a survey of clinicians to determine the extent to which the new guidelines had penetrated clinical practice, and compared these results with those of a previous survey. The responses to the current survey regarding the diagnosis and treatment had changed from those of the previous survey to reflect the new recommendations, showing that the guidelines have had an effect on clinical practice. However, the current survey highlights a need to provide more practical information in the guidelines for use in the clinical settings. In particular, physicians expect the guidelines to proactively provide more information about the features of both current and new drugs. In addition, an effective drug against the genus Aspergillus is eagerly awaited. However, because it is difficult to differentiate among filamentous fungi, there is a need for a drug with broad-spectrum coverage against filamentous fungi. Investigation of combination therapy consequently becomes necessary. Definitive diagnoses of invasive fungal infection are too scarce at the national level. The cooperation of clinicians for organizing more definitive diagnoses would be appreciated when the guidelines are revised.
authors.affiliation: Keio University Hospital, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan. aikawan@sc.itc.keio.ac.jp
authors.forename: Naoki
authors.initials: N
authors.lastname: Aikawa
authors.forename: Shigeru
authors.initials: S
authors.lastname: Kohno
authors.forename: Kazutoshi
authors.initials: K
authors.lastname: Shibuya
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Takesue
authors.forename: Shigefumi
authors.initials: S
authors.lastname: Maesaki
authors.forename: Minoru
authors.initials: M
authors.lastname: Yoshida
authors.forename: Issei
authors.initials: I
authors.lastname: Tokimatsu
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use*; D016469:Fungemia / Q000175:diagnosis* / Q000188:drug therapy*; D019983:Guideline Adherence; D006801:Humans; D007564:Japan; D009181:Mycoses / Q000175:diagnosis* / Q000188:drug therapy*; D017410:Practice Guidelines as Topic; D011795:Surveys and Questionnaires
chemical_list: D000935:Antifungal Agents