Title :

Systematic review on the first line treatment of amphotericin B in critically ill adults with candidemia or invasive candidiasis.

Author(s) :

Keane, Sean [Auteur]
Geoghegan, Pierce [Auteur]
Povoa, Pedro [Auteur]
Nseir, Saad [Auteur]
Lille Inflammation Research International Center (LIRIC) - U995
Rodriguez, Alejandro [Auteur]
Martin-Loeches, Ignacio [Auteur]

Journal title :

Expert Review of Anti-infective Therapy

Abbreviated title :

Expert Rev Anti Infect Ther

Volume number :

16

Pages :

839-847

Publication date :

2018

Keyword(s) :

echinocandins
intensive care unit
invasive candidiasis
voriconazole
critically ill
candida
Amphotericin B

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Introduction: Invasive candidiasis is the most common fungal infection affecting critically ill adults. International guidelines provide differing recommendations for first-line antifungal therapy, with echinocandins ...
Show more >Introduction: Invasive candidiasis is the most common fungal infection affecting critically ill adults. International guidelines provide differing recommendations for first-line antifungal therapy, with echinocandins considered first-line in the majority. Amphotericin B has broad activity and low minimum inhibitory concentration resistance patterns across most Candida species and guidance away from its use should be supported by the available evidence. Areas Covered: A systematic literature review was conducted from August to September 2017 to determine whether treatment with echinocandins or other available drugs, namely voriconazole, confers a therapeutic or survival benefit over amphotericin B in critically ill adults with invasive candidiasis. Inclusion criteria were: (1) studies describing critically ill adults with invasive candidiasis, (2) studies describing therapeutic benefit or survival as an outcome, and (3) studies comparing amphotericin B, deoxycholate or lipid preparations, with any newer antifungal agent. Eight studies were included in the final review, incorporating 2352 unique patients. No difference in treatment efficacy or mortality outcomes in critically ill patients with invasive candidiasis receiving an amphotericin B formulation compared with those receiving an echinocandin or voriconazole was shown. Expert Commentary: We conclude that in the existing literature, there is no evidence that choice between echinocandins, voriconazole, or amphotericin B formulations as first-line therapy for critically ill adults with invasive candidiasis is associated with a therapeutic or survival benefit. Clinicians must therefore consider other factors in the selection of first-line therapyShow less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

Inserm
Université de Lille
CHU Lille

Collections :

• Institut de Recherche Translationnelle sur l'Inflammation (INFINITE) - U1286

Research team(s) :

Fungal associated invasive and inflammatory diseases

Submission date :

2019-03-01T14:34:31Z
2024-01-29T12:37:36Z