Cited by 334Antifungal resistance and susceptibilityNeutropenia and Cancer InfectionsFungal Infections and Studies

ESCMID guideline for the diagnosis and management of Candida diseases 2012: adults with haematological malignancies and after haematopoietic stem cell transplantation (HCT)

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Ullmann, A.J., Akova, M., Herbrecht, R., Viscoli, C., Arendrup, M.C., Arikan-Akdagli, S., Bassetti, M., Bille, J. +17 more·2012·Clinical Microbiology and Infection

Abstract

Fungal diseases still play a major role in morbidity and mortality in patients with haematological malignancies, including those undergoing haematopoietic stem cell transplantation. Although Aspergillus and other filamentous fungal diseases remain a major concern, Candida infections are still a major cause of mortality. This part of the ESCMID guidelines focuses on this patient population and reviews pertaining to prophylaxis, empirical/pre-emptive and targeted therapy of Candida diseases. Anti-Candida prophylaxis is only recommended for patients receiving allogeneic stem cell transplantation. The authors recognize that the recommendations would have most likely been different if the purpose would have been prevention of all fungal infections (e.g. aspergillosis). In targeted treatment of candidaemia, recommendations for treatment are available for all echinocandins, that is anidulafungin (AI), caspofungin (AI) and micafungin (AI), although a warning for resistance is expressed. Liposomal amphotericin B received a BI recommendation due to higher number of reported adverse events in the trials. Amphotericin B deoxycholate should not be used (DII); and fluconazole was rated CI because of a change in epidemiology in some areas in Europe. Removal of central venous catheters is recommended during candidaemia but if catheter retention is a clinical necessity, treatment with an echinocandin is an option (CII(t) ). In chronic disseminated candidiasis therapy, recommendations are liposomal amphotericin B for 8 weeks (AIII), fluconazole for >3 months or other azoles (BIII). Granulocyte transfusions are only an option in desperate cases of patients with Candida disease and neutropenia (CIII).

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Crossref · 10.1111/1469-0691.12041

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  • Echinocandins have a broad spectrum of activity, favorable side effect profile, and mortality benefit in invasive candidiasis.

    “The most recent Infectious Disease Society of America (IDSA)125 and European guidelines126,127 recommend echinocandins as first-line initial treatment for most invasive candidiasis in both neutropenic and non-neutropenic patients prior to identification to the species level due to their broad spectrum of activity, favorable side effect profile, mortality benefit, and the increasing incidence of az”

    From Epidemiology of Invasive Candidiasis (2024) · cites this paper as [131]

  • There is an increasing incidence of azole resistance particularly among non-albicans Candida species.

    “The most recent Infectious Disease Society of America (IDSA)125 and European guidelines126,127 recommend echinocandins as first-line initial treatment for most invasive candidiasis in both neutropenic and non-neutropenic patients prior to identification to the species level due to their broad spectrum of activity, favorable side effect profile, mortality benefit, and the increasing incidence of az”

    From Epidemiology of Invasive Candidiasis (2024) · cites this paper as [131]

  • The shift from C. albicans to species that are more frequently resistant or tolerant to fluconazole, such as C. glabrata and C. krusei, has impacted treatment recommendations.

    “The shift from C. albicans, which is overwhelmingly susceptible to all systemic antifungals, to species that are more frequently resistant or tolerant to fluconazole, such as C. glabrata and C. krusei, has impacted treatment recommendations [11,12,13].”

    From Treatment of Invasive Candidiasis: A Narrative Review (2018) · cites this paper as [13]

  • The echinocandins display in vitro fungicidal activity against most Candida species.

    “They display in vitro fungicidal activity against most Candida species, attractive tolerability and pharmacokinetic profiles, and have been recommended as first line agents for invasive candidiasis (1–6).”

    From Echinocandin resistance: an emerging clinical problem? (2014) · cites this paper as [5]

  • The echinocandins have been recommended as first-line agents for invasive candidiasis.

    “They display in vitro fungicidal activity against most Candida species, attractive tolerability and pharmacokinetic profiles, and have been recommended as first line agents for invasive candidiasis (1–6).”

    From Echinocandin resistance: an emerging clinical problem? (2014) · cites this paper as [5]

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Authors
Ullmann, A. J., Akova, M., Herbrecht, R., Viscoli, C., Arendrup, M. C., Arikan-Akdagli, S., Bassetti, M., Bille, J., Calandra, T., Castagnola, E., Cornely, O. A., Donnelly, J. P., Garbino, J., Groll, A. H., Hope, W. W., Jensen, H. E., Kullberg, B. J., Lass-Flörl, C., Lortholary, O., Meersseman, W., Petrikkos, G., Richardson, M. D., Roilides, E., Verweij, P. E., & Cuenca-Estrella, M.
Affiliations
  • University of Würzburg (DE)
  • Hacettepe University (TR)
  • Hôpital d'Hautepierre (FR)
  • University of Genoa (IT)
  • Statens Serum Institut (DK)
  • Ospedale Santa Maria della Misericordia di Udine (IT)
  • Centre Hospitalier Universitaire Vaudois (CH)
  • Istituto Giannina Gaslini (IT)
  • University of Cologne (DE)
  • Radboud University Medical Center (NL)
  • University Hospital of Geneva (CH)
  • University Hospital Münster (DE)
  • University of Liverpool (GB)
  • University of Copenhagen (DK)
  • Hôpital Necker-Enfants Malades (FR)
  • Universitair Ziekenhuis Leuven (BE)
  • National and Kapodistrian University of Athens (GR)
  • Manchester Academic Health Science Centre (GB)
  • Aristotle University of Thessaloniki (GR)
Corresponding author
Ullmann, A.J.
Venue
Clinical Microbiology and Infection
Publisher
Elsevier BV
Published
2012-12
Volume
18
Pages
53-67
ISSN
1198-743X (ISSN-L)
OpenAlex
W2037123829
Cited by
334
References
165
Citations by year
2026: 7 · 2025: 13 · 2024: 13 · 2023: 19 · 2022: 17 · 2021: 24 · 2020: 19 · 2019: 23 · 2018: 34 · 2017: 43 · 2016: 24 · 2015: 37 · 2014: 34 · 2013: 24 · 2012: 2
FWCI
21.42
Type
journal article
Language
en
Open access
Locations
  • Clinical Microbiology and Infection (publishedVersion)
  • PubMed (publishedVersion)
  • Kölner Universitäts PublikationsServer (Universität zu Köln) (publishedVersion)
  • Research Explorer (The University of Manchester) (publishedVersion)
  • Institutional Research Information System (University of Udine) (submittedVersion)
  • CINECA IRIS Institutial Research Information System (University of Genoa) (submittedVersion)
  • IRIS (submittedVersion)
  • Hacettepe University Institutional Repository (hacettepe.edu.tr) (submittedVersion, other-oa)
  • Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
  • Radboud Repository (Radboud University) (submittedVersion)
  • SERVAL (Université de Lausanne) (submittedVersion)
Funders
National Institute for Health and Care Research (CS/08/08/10)
Topics
  • Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
  • Health Sciences › Medicine › Oncology › Neutropenia and Cancer Infections
  • Health Sciences › Medicine › Epidemiology › Fungal Infections and Studies
Keywords
candidiasis, candidemia, chronic disseminated candidiasis, hematologic malignancies, hematopoietic stem cell transplantation, antifungal prophylaxis, echinocandins, anidulafungin, caspofungin, micafungin, liposomal amphotericin B, fluconazole, central venous catheter removal, granulocyte transfusion, neutropenia, antifungal resistance
MeSH terms
Adult, Antifungal Agents, Candidiasis, Catheterization, Central Venous, Humans, Neutropenia, Hematopoietic Stem Cell Transplantation, Evidence-Based Medicine, Hematologic Neoplasms

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