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ESCMID guideline for the diagnosis and management of Candida diseases 2012: adults with haematological malignancies and after haematopoietic stem cell transplantation (HCT)
Open accessAbstract
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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“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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]
In the citing paper
“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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Metadata
- 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.
- ORCID
- 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
- bronze
- doi.org
- Licence
- 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 › Infectious Diseases › 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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