Tuesday October 5, 2005
Candidiasis - changing spectrum of species
Prophylactic coverage with Diflucan (fluconazole) is still very valid for fungal infections but note that spectrum of candidal infection is progressively showing change from albicans to non-albicans (C. Krusei and C. glabrata) species. It reminds us that Amphotericin B (though we call it Amphoterrible) is still a major player. Also, availability of Caspofungin (Cancidas) is a big relief with better side effect profile.
Recommended Readings: Click on links to go to reference
1. Increase in prevalence of nosocomial non-Candida albicans candidaemia and the association of Candida krusei with fluconazole use. J Hosp Infect. 2002 Jan;50(1):56-65
2. The changing face of nosocomial candidemia: epidemiology, resistance, and drug therapy. - Am J Health Syst Pharm. 1999 Mar 15;56(6):525-33
3. Comparison of Caspofungin and Amphotericin B for Invasive Candidiasis - NEJM - 12/2002
4. Caspofungin versus Liposomal Amphotericin B for Empirical Antifungal Therapy in Patients with Persistent Fever and Neutropenia - NEJM 09/2004