Pais Marco Marotta, Zaragoza Rafael, Martín-Loeches Ignacio, Gómez-Bertomeu Frederic F, Rodríguez Alejandro
Critical Care Department, Hospital Universitari de Tarragona Joan XXIII, Mallafré Guasch 4, 43007 Tarragona, Spain.
Department of Medicine and Surgery, Faculty of Medicine and Health Sciences, Rovira & Virgili University, 43005 Tarragona, Spain.
J Fungi (Basel). 2025 May 6;11(5):362. doi: 10.3390/jof11050362.
Intra-abdominal candidiasis (IAC), with or without candidemia, is a common condition in patients in intensive care units (ICUs). Early diagnosis of IAC remains a challenge for clinicians despite new biomarkers. Early and appropriate antifungal treatment, which is associated with better clinical outcomes, is negatively affected by the increased isolation of non-albicans strains that are resistant to the commonly used azoles and echinocandins. Based on the pharmacokinetic (PK) and pharmacodynamic (PD) properties of the different treatment options, liposomal amphotericin B, rezafungin or high doses of anidulafungin appear to be the most appropriate first-line options for complicated IAC in ICUs.
腹内念珠菌病（IAC），无论有无念珠菌血症，在重症监护病房（ICU）患者中都是一种常见病症。尽管有新的生物标志物，但IAC的早期诊断对临床医生来说仍是一项挑战。早期且恰当的抗真菌治疗与更好的临床结果相关，但常用唑类和棘白菌素耐药的非白念珠菌菌株分离增加对其产生了负面影响。基于不同治疗方案的药代动力学（PK）和药效学（PD）特性，脂质体两性霉素B、瑞扎芬净或高剂量阿尼芬净似乎是ICU中复杂性IAC最合适的一线治疗选择。
