Эмпирическая терапия инвазивного кандидоза в отделениях реанимации и интенсивной терапии: современное состояние проблемы

Клиническая Микробиология и Антимикробная Химиотерапия. 2011; 13(1):4-18

​ Веселов А.В.
Candida инвазивный кандидоз ОРИТ антимикотики эмпирическая терапия
Раздел
Болезни и возбудители
Тип
Журнальная статья
Публикация
Клиническая Микробиология и Антимикробная Химиотерапия. 2011; 13(1):4-18

Аннотация

Высокая распространённость инвазивного кандидоза (ИК) в условиях отделений реанимации и интенсивной терапии (ОРИТ) является одной из наиболее значимых проблем медицинской микологии и современной медицины в целом. Более 10% всех случаев инфекций в ОРИТ обусловлено грибами рода Candida. Инфекции, вызванные грибами рода Candida, связаны с высокими показателями смертности, в том числе и у пациентов в ОРИТ. Высокие показатели атрибутивной летальности и смена эпидемиологии возбудителей ИК требуют чёткого подхода со стороны клинициста в отношении выбора адекватных препаратов, прежде всего для эмпирической терапии. В настоящее время препараты выбора для эмпирической терапии ИК в ОРИТ ограничены эхинокандинами и азолами. Принимая во внимание важность использования стратегии деэскалационной терапии, эхинокандины в подавляющем большинстве случаев являются препаратами первой линии, учитывая их хороший профиль безопасности и сохраняющуюся высокую фунгицидную активность в отношении грибов рода Candida. В данном обзоре представлены основные подходы к выбору противогрибковых препаратов для эмпирической терапии инвазивного кандидоза у пациентов в ОРИТ.

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