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J Microbiol Immunol Infect. 2018 Feb;51(1):1-17. doi: 10.1016/j.jmii.2017.07.006. Epub 2017 Jul 25.

2016 guidelines for the use of antifungal agents in patients with invasive fungal diseases in Taiwan.

Author information

1
Division of Infectious Diseases, Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan.
2
Division of Infectious Diseases, Department of Medicine, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan.
3
Division of Infectious Diseases, Department of Internal Medicine, Koo Foundation Sun Yat-Sen Cancer Center, Taipei, Taiwan.
4
Division of Hematology, Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan; Department of Medicine, National Taiwan University, College of Medicine, Taipei, Taiwan.
5
Division of Infectious Diseases, Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan; Department of Medicine, National Taiwan University, College of Medicine, Taipei, Taiwan. Electronic address: yeechunchen@gmail.com.
6
Division of Infectious Diseases, Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan; Department of Medicine, National Taiwan University, College of Medicine, Taipei, Taiwan.
7
Departments of Medical Research and Medicine, Chi Mei Medical Center, Taiwan.

Abstract

The Infectious Diseases Society of Taiwan, Medical Foundation in Memory of Dr. Deh-Lin Cheng, Foundation of Professor Wei-Chuan Hsieh for Infectious Diseases Research and Education, and CY Lee's Research Foundation for Pediatric Infectious Diseases and Vaccines have updated the guidelines for the use of antifungal agents in adult patients with invasive fungal diseases in Taiwan. This guideline replaces the 2009 version. Recommendations are provided for Candida, Cryptococcus, Aspergillus and Mucormycetes. The focus is based on up-to-date evidence on indications for treatment or prophylaxis of the most common clinical problems. To support the recommendations in this guideline, the committee considered the rationale, purpose, local epidemiology, and key clinical features of invasive fungal diseases to select the primary and alternative antifungal agents. This is the first guideline that explicitly describes the quality and strength of the evidence to support these recommendations. The strengths of the recommendations are the quality of the evidence, the balance between benefits and harms, resource and cost. The guidelines are not intended nor recommended as a substitute for bedside judgment in the management of individual patients, the advice of qualified health care professionals, and more recent evidence concerning therapeutic efficacy and emergence of resistance. Practical considerations for individualized selection of antifungal agents include patient factors, pathogen, site of infection and drug-related factors, such as drug-drug interaction, drug-food intervention, cost and convenience. The guidelines are published in the Journal of Microbiology, Immunology and Infection and are also available on the Society website.

KEYWORDS:

Antifungal therapy; Aspergillosis; Candidiasis; Cryptococcosis; Definitive therapy; Mucormycosis

PMID:
28781150
DOI:
10.1016/j.jmii.2017.07.006
[Indexed for MEDLINE]
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