Diagnosis and Treatment of Candidemia in the Intensive Care Unit

Semin Respir Crit Care Med. 2019 Aug;40(4):524-539. doi: 10.1055/s-0039-1693704. Epub 2019 Oct 4.

Abstract

Candidemia is the fourth most frequent health care-associated bloodstream infection, and the most frequent severe fungal infection developing in critically ill patients in intensive care units (ICUs). Diagnosis of candidemia in ICU patients is a complex task made of both early and late assessments involving both conventional diagnostic methods and novel rapid tests. Management strategies to optimize treatment of candidemia can be challenging and include starting early adequate therapy, use of an adequate dose and duration of therapy, de-escalating treatment whenever possible, and early discontinuation of useless antifungals in those with no definitive diagnosis of fungal infection. Herein, we will discuss recent epidemiological data on candidemia in ICUs and current diagnostic techniques before concentrating on antifungal treatments.

Publication types

  • Review

MeSH terms

  • Antifungal Agents / therapeutic use
  • Candidemia / diagnosis*
  • Candidemia / drug therapy*
  • Candidemia / prevention & control
  • Candidiasis, Invasive / diagnosis*
  • Candidiasis, Invasive / drug therapy*
  • Candidiasis, Invasive / prevention & control
  • Chemoprevention / methods
  • Critical Illness
  • Humans
  • Intensive Care Units
  • Randomized Controlled Trials as Topic

Substances

  • Antifungal Agents