title: Current recommendations and importance of antifungal stewardship for the management of invasive candidiasis.
abstract: Invasive candidiasis can have a major effect on patient prognosis and medical economics. Quickly eliminating the focus of the infection and administering appropriate antifungal therapy are important. Clinical guidelines for invasive candidiasis have been issued in the USA, Europe and recently in Japan. The purpose of this review is to summarize the current recommendations on how to diagnose and treat invasive candidiasis based on the evidence gathered to date and by referencing guidelines from various countries. Echinocandin antifungals play a central role in the prevention and treatment of invasive candidiasis although a recent increase in echinocandin-resistant Candida glabrata is seen as problematic. In the future, promoting the appropriate use of antifungal agents by antifungal stewardship teams will be necessary to suppress adverse effects, appearance of resistant strains and unnecessary medical expenses, as well as improve positive clinical outcomes and prognoses.
authors.affiliation: Second Department of Internal Medicine, Nagasaki University, Nagasaki, Japan.
authors.forename: Taiga
authors.initials: T
authors.lastname: Miyazaki
authors.forename: Shigeru
authors.initials: S
authors.lastname: Kohno
mesh_terms: D000818:Animals; D000935:Antifungal Agents / Q000494:pharmacology / Q000627:therapeutic use*; D041221:Candida glabrata / Q000187:drug effects* / Q000502:physiology; D058365:Candidiasis, Invasive / Q000175:diagnosis / Q000188:drug therapy*; D019468:Disease Management; D025141:Drug Resistance, Fungal / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D008826:Microbial Sensitivity Tests / Q000379:methods; D017410:Practice Guidelines as Topic / Q000592:standards
chemical_list: D000935:Antifungal Agents
keywords: Candida glabrata; antifungal resistance; antifungal stewardship; candidemia; echinocandin; invasive candidiasis