title: Management of invasive candidiasis and candidemia in adult non-neutropenic intensive care unit patients: Part II. Treatment.
abstract: BACKGROUND
  Invasive candidiasis and candidemia are frequently encountered in the nosocomial setting particularly in the intensive care unit (ICU).
  
  
  OBJECTIVE
  To review the current management of invasive candidiasis and candidemia in non-neutropenic adult ICU patients based on a review of the literature and an European expert panel discussion.
  
  
  CONCLUSIONS
  Empiric and directed treatment for invasive candidiasis are predicated on the hemodynamic status of the patient. Unstable patients may benefit from broad-spectrum antifungal agents, which can be narrowed once the patient has stabilized and the identity of the infecting species is established. In stable patients, a more classical approach using fluconazole may be satisfactory provided that the patient is not colonized with fluconazole resistant strains or there has been recent past exposure to an azole (<30 days). In contrast, pre-emptive therapy is based on the presence of surrogate markers.
authors.affiliation: Infectious Diseases, SGRIVI, Hopital Huriez, CHRU Lille, 59045, Lille Cedex, France.
authors.forename: Benoît P
authors.initials: BP
authors.lastname: Guery
authors.forename: Maiken C
authors.initials: MC
authors.lastname: Arendrup
authors.forename: Georg
authors.initials: G
authors.lastname: Auzinger
authors.forename: Elie
authors.initials: E
authors.lastname: Azoulay
authors.forename: Márcio
authors.initials: M
authors.lastname: Borges Sá
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Johnson
authors.forename: Eckhard
authors.initials: E
authors.lastname: Müller
authors.forename: Christian
authors.initials: C
authors.lastname: Putensen
authors.forename: Coleman
authors.initials: C
authors.lastname: Rotstein
authors.forename: Gabriele
authors.initials: G
authors.lastname: Sganga
authors.forename: Mario
authors.initials: M
authors.lastname: Venditti
authors.forename: Rafael
authors.initials: R
authors.lastname: Zaragoza Crespo
authors.forename: Bart Jan
authors.initials: BJ
authors.lastname: Kullberg
mesh_terms: D000666:Amphotericin B / Q000627:therapeutic use*; D000935:Antifungal Agents / Q000627:therapeutic use*; D016470:Bacteremia / Q000097:blood* / Q000382:microbiology*; D002176:Candida albicans / Q000302:isolation & purification*; D002177:Candidiasis / Q000188:drug therapy* / Q000382:microbiology*; D015725:Fluconazole / Q000627:therapeutic use*; D006801:Humans; D007362:Intensive Care Units
chemical_list: D000935:Antifungal Agents; D000666:Amphotericin B; D015725:Fluconazole