کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
---|---|---|---|---|
5679048 | 1596532 | 2016 | 9 صفحه PDF | دانلود رایگان |

- Patient's stratification for clinical severity and risk of IC is pivotal.
- In symptomatic patients, a microbiological diagnosis should be pursued.
- In stable patients, a watchful waiting approach until diagnosis is appropriate.
- In critically ill patients, first-line therapy with an echinocandin is necessary.
- In patients with proven infection, early antifungal therapy is warranted.
IntroductionA majority of invasive Candida infections occur in medical wards; however, evidence for management in this setting is scarce and based primarily on the intensive care or surgical setting. On behalf of the Italian Society for Anti-Infective Therapy (SITA) and the Italian Federation of Associations of Hospital Doctors on Internal Medicine (FADOI), the MEDICAL group produced practical management algorithms for patients in internal medicine wards.MethodsThe MEDICAL group panel, composed of 30 members from internal medicine, infectious disease, clinical pharmacology, clinical microbiology and clinical epidemiology, provided expert opinion through the RAND/UCLA method.ResultsSeven clinical scenarios were constructed based on clinical severity and probability of invasive candidiasis. For each scenario, the appropriateness of 63 different diagnostic, imaging, management, or therapeutic procedures was determined in two Delphi rounds. The necessity for performing each appropriate procedure, was then determined in a third Delphi round. Results were summarized in algorithms.DiscussionThe proposed algorithms provide internal medicine physicians and managers with an easy to interpret tool that is exhaustive, clear and suitable for adaption to individual local settings. Attention was paid to individual patient management and resource allocation.
Journal: European Journal of Internal Medicine - Volume 34, October 2016, Pages 45-53