Dib Rita Wilson, Hachem Ray, Chaftari Anne-Marie, Raad Issam
The University of Texas M. D. Anderson Cancer Center, Department of Infectious Diseases, Infection Control and Employee Health, 1515 Holcombe, Unite 1460, Houston, Texas, 77030.
Mediterr J Hematol Infect Dis. 2018 May 1;10(1):e2018028. doi: 10.4084/MJHID.2018.028. eCollection 2018.
In this review, we have analyzed the available literature pertaining to the total duration of intravenous (IV) therapy and the appropriate timing of step down to oral therapy in the management of candidemia. Overview of the guidelines and literature seem to indicate that a minimum of 14 days of antifungal therapy is required in the treatment of candidemia without deeply seated infection. However, this was never based on evidence. Furthermore, step down to oral therapy seems to be dependent on the clinical stability criteria of the patient with candidemia after 4 to 7 days of IV therapy. Further studies are required to evaluate the appropriate total duration of IV therapy, appropriate timing of step down to oral therapy and to validate the clinical criteria that would allow the switch to happen.
在本综述中，我们分析了关于念珠菌血症治疗中静脉注射（IV）治疗的总时长以及降阶梯至口服治疗的合适时机的现有文献。指南和文献综述似乎表明，在治疗无深部感染的念珠菌血症时，至少需要14天的抗真菌治疗。然而，这从未基于证据。此外，降阶梯至口服治疗似乎取决于念珠菌血症患者在静脉注射治疗4至7天后的临床稳定性标准。需要进一步的研究来评估静脉注射治疗的合适总时长、降阶梯至口服治疗的合适时机，并验证允许进行转换的临床标准。
