title: Treatment of invasive candidiasis: between guidelines and daily clinical practice.
abstract: Invasive candidiasis, including candidemia (IC/C), is a major cause of morbidity and mortality among hospitalized patients. While incidence is higher in intensive care units, the majority of cases of candidemia are documented in medical wards. Although Candida albicans is still the most frequently isolated species, IC/C due to non-albicans species, usually less susceptible to fluconazole, is increasing. Early identification of patients at risk, knowledge of local epidemiology and prompt efforts to define etiologic diagnosis play a pivotal role for appropriateness. Starting therapy with an echinocandin, switching then to fluconazole when possible, seems to represent a potentially useful strategy for the management of IC/C. The choice between the three echinocandins should be based on the specific indications, pharmacokinetic/pharmacodynamic profile, clinical experience and relative cost.
authors.affiliation: UOC Malattie Infettive, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Tagliaferri
authors.forename: Francesco
authors.initials: F
authors.lastname: Menichetti
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use*; D002175:Candida / Q000187:drug effects*; D058387:Candidemia / Q000188:drug therapy*; D058365:Candidiasis, Invasive / Q000188:drug therapy*; D019468:Disease Management; D054714:Echinocandins / Q000145:classification / Q000191:economics / Q000627:therapeutic use*; D015725:Fluconazole / Q000627:therapeutic use*; D006801:Humans; D007362:Intensive Care Units
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins; D015725:Fluconazole
keywords: antifungals; candidemia; invasive candidiasis