Liver dysfunctions in intensive care patients-consequences for the treatment of invasive Candida infections

被引:0
作者
Canbay, A. E. [1 ]
Gloeckner, A. [2 ]
机构
[1] Univ Klinikum Essen, Essen, Germany
[2] BDH Klin Greifswald, D-17491 Greifswald, Germany
关键词
Liver dysfunction; Intensive care; Anidulafungin; Candidiasis; invasive; Candidemia; CRITICALLY-ILL PATIENTS; ESCMID-ASTERISK GUIDELINE; ANIDULAFUNGIN; MORTALITY; HEPATOTOXICITY; FLUCONAZOLE; MANAGEMENT; DIAGNOSIS; THERAPY; INJURY;
D O I
10.1007/s00063-013-0262-y
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Liver dysfunction is common among patients on intensive care units (ICU) due to sepsis, chronic liver disease, ischemic hepatitis, drug toxicity and intensive care measures. Critically ill patients with invasive fungal infections should therefore be treated with antifungals that are not metabolized by the liver. This may help to avoid therapeutic complications by drug accumulation, inadequate dosages or drug-drug interactions. Echinocandins are established as the antifungal class of choice in the treatment of invasive Candida infections. Anidulafungin is not hepatically metabolized and may be used without dose adjustments in patients with severe liver dysfunction. It has no known clinically relevant drug interactions. In the primary endpoint of the randomized pivotal trial in patients with candidemia or invasive candidiasis, anidulafungin was statistically superior versus the former standard therapy (fluconazole), with a favourable overall safety profile. More recent study data particularly in ICU patients confirm the efficacy of anidulafungin for these patient groups. Therefore, anidulafungin is an important antifungal treatment option for patients with liver dysfunction.
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页码:138 / 144
页数:7
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