Immunité antifongique - epgonline.org
Immunité antifongique - epgonline.org
Immunité antifongique - epgonline.org
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Critically ill patient<br />
Dimopoulos G et al J Crit Care 2013 (in press)<br />
Suspected<br />
Fungal infection<br />
Proven Blood cultures (+)<br />
Biopsy (+)<br />
Targeted treatment according to<br />
- Guidelines<br />
- Local Epidemiology<br />
Risk factors (+)<br />
Clinical signs (-)<br />
Biomarkers (-)<br />
Mycology (-)<br />
Risk factors (+)<br />
Biomarkers (+)<br />
Clinical signs (-)<br />
Mycology (-)<br />
Risk factors (+)<br />
Clinical signs (+)<br />
Biomarkers (-)<br />
Mycology (-)<br />
How to select the antifungal agent <br />
Hemodynamically unstable patient<br />
Prophylaxis<br />
Fluconazole<br />
Pre-emptive<br />
Treatment<br />
Empirical<br />
treatment<br />
NO<br />
YES<br />
Echinocandins<br />
YES<br />
Azole resistance<br />
Recent exposure<br />
Local epidemiology<br />
Colonization<br />
Echinocandins<br />
Patient is stabilized <br />
Consider step-down to<br />
Voriconazole or Fluconazole<br />
Alternative<br />
L-AmphoB<br />
Alternatives<br />
-Echinocandins<br />
-Voriconazole<br />
-L-AmphoB<br />
NO<br />
FLUCONAZOLE
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