Abstract
Invasive candidiasis is a third or fourth cause of sepsis in intensive care units (ICUs). Clinical and pharmacoeconomic study of treatment for invasive candidiasis was first performed using mathematical modeling in Russian economic environment. ICU patients without neutropenia who have received primary prophylaxis with azoles and/or patients from ICUs with the high rate (>20%) of fluconazole resistance in Candida (based on data from national or local studies) were used in the model. Use of caspofungin or amphotericin B was analyzed as a model of initial therapy for invasive candidiasis. If the initial treatment with amphotericin B was failed then the use of caspofungin or amphotericin B lipid complex was analyzed. If the initial treatment with caspofungin was failed then the use of amphotericin B lipid complex was analyzed. Alternative scenario was also tested, and one-sided sensitivity analysis was performed. Results of the study showed that amphotericin B with change to caspofungin (in cases of treatment failure or severe adverse events) was the most appropriate initial therapy of invasive candidiasis at high rate of resistance to fluconazole in Candida spp.
-
1.
Fridkin SK. The changing face of fungal infections in health care settings. Clin Infect Dis 2005; 41:1455-60.
-
2.
Wisplinghoff H., Bischoff T., Tallent S.M., et al. Nosocomial bloodstream infections in US hospitals: analysis of 24,179 cases from a prospective nationwide surveillance study. Clin Infect Dis 2004; 39:309-17.
-
3.
Pappas P., Kauffman C., Andes D., et al. Infectious Diseases Society of America. Clinical practice guidelines for the management of candidiasis: 2009 update by the In-fectious Diseases Society of America. Clin Infect Dis. 2009;1;48(5):503-35.
-
4.
Guery B., Arendrup M., Auzinger G., et al. Management of invasive candidiasis and candidemia in adult non-neutropenic intensive care unit patients: Part II. Treatment. Intensive Care Med. 2008.
-
5.
Zaoutis T.E., Argon J., Chu J., et al. The epidemiology and attributable outcomes of candidemia in adults and children hospitalized in the United States: a propensity analysis. Clin Infect Dis 2005; 41:1232-9.
-
6.
Gilbert D.N., Moellering R.C., Epiopoulos G.M., Sande M.A., editors. The Sanford guide to antimicrobial therapy (thirty-ninth edition). USA; 2009.
-
7.
Клинико-экономический анализ (оценка, выбор медицинских технологий и управление качеством медиццинской помощи) / М.А. Авксентьев, В.Б. Герасимов, М.В.Сура / Под ред. П.А. Воробьева.- М.: Ньюдиамед, 2004.-404 с
-
8.
Планирование и проведение клинических исследований лекарственных средств / Ю.Б. Белоусов [и др.]. - М. : Общество клинических исследователей, 2000.- 579 с.
-
9.
Система стандартизации в здравоохранении Российской Федерации. Отраслевой стандарт клинико-экономического исследования. Общие положения 91500.14.0001-2002. Министерство Здравоохранения Российской Федерации. Приказ от 27 мая 2002 года N 163.
-
10.
Бюллетень для оптовых покупателей и поставщиков медикаментов «Фарминдекс» (www.pharmindex.ru).
-
11.
Климко Н.Н. Микозы: диагностика и лечение. Руководство для врачей. 2-е изд. перераб. и доп. - М.: Ви Джи Групп, 2008. - 336 с.
-
12.
Weinstein M., O’Brien B., Hornberger J., et al. Principles of good practice of decision analytic modeling in health care evaluation: Report of the ISPOR Task Force on Good Research Practices-Modeling Studies.Value Health 2003; 6:9-17.
-
13.
Kujath P., Lerch K., Kochendorfer P., et al. Comparative study of the efficacy of fluconazole versus amphotericin B/flucytosine in surgical patients with systemic mycoses. Infection. 1993; 21:376-382.
-
14.
Phillips P., Shafran S., Garber G., et al. : Multicenter randomized trial of fluconazole versus amphotericin B for treatment of candidemia in non-neutropenic patients. Canadian Candidemia Study Group. Eur. J. Clin. Microbiol. Infect. Dis. 1997;16 : 337 -45.
-
15.
Mora-Duarte J., Betts R., Rotstein C., et al. Comparison of caspofungin and amphotericin B for invasive candidiasis. N Engl J Med 2002; 347:2002-9.
-
16.
Rex J., Pappas P., Karchmer A., et al. A randomized and blinded multicenter trial of high-dose fluconazole plus placebo versus fluconazole plus amphotericin B as therapy for candidemia and its consequences in nonneutropenic subjects. Clin Infect Dis 2003; 36:1221-8.
-
17.
Ostrosky-Zeichner L., Oude Lashof A., Kullberg B., et al. Voriconazole salvage treatment of invasive candidiasis. Eur J Clin Microbiol Infect Dis 2003; 22:651-5.
-
18.
Kullberg B., Sobel J., Ruhnke M., et al. Voriconazole versus a regimen of amphotericin B followed by fluconazole for candidaemia in non-neutropenic patients: a randomised non-inferiority trial. Lancet. 2005;366(9495):1435-42.
-
19.
Reboli A., Rotstein C., Pappas P., et al. Anidulafungin versus fluconazole for invasive candidiasis. N Engl J Med 2007; 356:2472-82.
-
20.
Pappas P., Rotstein C., Betts R., et al. Micafungin versus caspofungin for treatment of candidemia and other forms of invasive candidiasis. Clin Infect Dis 2007; 45:883-93.
-
21.
Веселов А.В., Климко Н.Н., Кречикова О.И. и др. In vitro активность флуконазола и вориконазола в отношении более 10 000 штаммов дрожжей: результаты 5-летнего проспективного исследования ARTEMIS Disk в России. Клин микробиол антимикроб химиотер 2008; 10(4):345-54.
-
22.
Playford E., Eggimann P., Calandra T. Antifungals in the ICU. Curr Opin Infect Dis. 2008; 21:610-9.
-
23.
Bruynesteyn K., Gant V., McKenzie C., et al. A cost-effectiveness analysis of caspofungin vs. liposomal amphotericin B for treatment of suspected fungal infections in the UK. Eur J Haematol. 2007; 78:532-9.