, Volume 35, Issue 4, pp 582-584
Date: 11 Feb 2009

On track to limit antifungal overuse!

This is an excerpt from the content

Invasive candidiasis (IC) has emerged as a main cause of morbidity and mortality among critically ill patients. Candida colonization at multiple sites promoted by prolonged exposure to antibiotics, intravascular devices for parenteral nutrition or renal replacement therapy, and complicated abdominal surgery are associated with the development of IC [1]. The gastrointestinal tract and endovascular catheters are thus the most common sources of IC [2].

Early recognition and appropriate management of IC are crucial for outcome [3, 4]. However, the sensitivity of conventional blood cultures remains limited. The utility of fungal blood markers such as beta-(1,3)-d-glucan or mannan/antimannan and PCR testing for the early diagnosis of IC needs to be confirmed in the ICU setting [5, 6]. Pending the conclusion on ongoing investigations and on the role of composite clinical scores which may improve the prediction of IC, therapeutic decisions remain essentially based on the clinical risk profile [

This editorial refers to the article available at: doi:10.1007/s00134-009-1431-6.
An erratum to this article can be found at http://dx.doi.org/10.1007/s00134-009-1459-7