血液系统疾病患者丝状真菌所致侵袭性真菌感染的治疗建议

Recommendations for the treatment of invasive fungal infection caused by filamentous fungi in the hematological patient.

作者信息

Barberán José, Mensa Josep, Llamas Juan Carlos Vallejo, Ramos Isidro Jarque, Ruiz Juan Carlos García, Marín José Rafael Cabrera, Tello Patricia Baltasar, Massana Montse Batlle, Vidal Juan Besalduch, Viñas José Manuel Calvo, Huelva Francisco Javier Capote, Pons Enric Carreras, Mediavilla Joaquín Díaz, Morfa Miguel L Díaz, Barrigón Fernando Escalante, Avellán Pascual Fernández, López Sebastián Garzón, García Carlos Grande, Maraver Dolores Hernández, Guía Ana López de la, Jiménez Javier López, Chacón Eusebio Martín, Rubio Mayte Olave, Oteyza Jaime Pérez de, Ramírez Gemma Ramírez, Contreras Rafael Rojas, Barbero Alejandro Román, Tarrats Montserrat Rovira, Félix Daniel Rubio, Godoy Pedro Sánchez, Salinas Andrés Sánchez, Alonso Miguel A Sanz, Torroba Javier de la Serna, Ferreiras David Valcárcel, López Lourdes Vázquez, García José M Aguado, Perea José Ramón Azanza, Moreno Rafael Cantón, Cáncer Ramón Cisterna, Abete Jesús Fortún, Rodríguez Julio García, Gómez Joaquín Gómez, Pedrosa Elia Gómez García de la, Baranda José Miguel Montejo, García F Javier Pemán, Camps Isabel Ruiz, Lleti Miguel Salavert, Cisneros Julián de la Torre

机构信息

Servicio de Enfermedades Infecciosas, Hospital Central de la Defensa Gómez Ulla, E-28047 Madrid, Spain.

出版信息

Rev Esp Quimioter. 2011 Dec;24(4):263-70.

PMID:22173196

Abstract

Antifungal treatment in the hematological patient has reached a high complexity with the advent of new antifungals and diagnostic tests, which have resulted in different therapeutic strategies. The use of the most appropriate treatment in each case is essential in infections with such a high mortality. The availability of recommendations as those here reported based on the best evidence and developed by a large panel of 48 specialists aimed to answer when is indicated to treat and which agents should be used, considering different aspects of the patient (risk of fungal infection, clinical manifestations, galactomanann test, chest CT scan and previous prophylaxis) may help clinicians to improve the results.

摘要

随着新型抗真菌药物和诊断检测方法的出现，血液科患者的抗真菌治疗变得高度复杂，这导致了不同的治疗策略。在这类死亡率很高的感染中，针对每种情况使用最合适的治疗方法至关重要。像这里所报告的基于最佳证据并由48位专家组成的大型小组制定的建议，旨在回答何时需要治疗以及应使用哪些药物，同时考虑患者的不同方面（真菌感染风险、临床表现、半乳甘露聚糖检测、胸部CT扫描和既往预防措施），这可能有助于临床医生改善治疗效果。