Treatment of invasive candidiasis in the era of Candida resistance

• Type: Another Publication in an International Scientific Journal
• Date: 2023

Authors

Paiva, J-A (Author) FMUP; Pereira, JM (Author) Other

Journal

The Journal is awaiting validation by the Administrative Services.

Title: CURRENT OPINION IN CRITICAL CARE

Vol. 29

Pages: 457-462

ISSN: 1070-5295

Publisher: Lippincott Williams & Wilkins

Indexing

ISI Web of Knowledge - 0 Citations

Scopus - 0 Citations

Other information

Authenticus ID: P-00Z-0ZM

DOI: 10.1097/mcc.0000000000001077

Abstract (EN): Purpose of reviewThe increasing incidence of drug-resistant Candida brings a new challenge to the treatment of invasive candidiasis. Although cross-resistance among azoles and echinocandins was generally uncommon, reports of multidrug-resistant (MDR) Candida markedly increased in the last decade. The purpose of this review is to understand mechanisms and risk factors for resistance and how to tackle antifungal resistance.Recent findingsThe paper describes the action of the three main classes of antifungals - azoles, echinocandins and polyenes - and Candida's mechanisms of resistance. The current evolution from cross-resistance to multiresistance among Candida explains the modern glossary - multidrug-resistant (MDR), extensively drug-resistant (XDR), and pandrug-resistant (PDR) - imported from bacteria. MDR Candida most commonly involves acquired resistance in species with intrinsic resistance, therefore it mostly involves C. glabrata, C. parapsilosis, C. krusei, C guilliermondii or C. auris, which is intrinsically multidrug resistant. Finally, strategies to tackle antifungal resistance became clearer, ideally implemented through antifungal stewardship.SummaryAvoiding antifungal's overuse and selecting the best drug, dose and duration, when they are needed, is fundamental. Knowledge of risk factors for resistance, microbiological diagnosis to the species, use of susceptibility test supported by antifungal stewardship programs help attaining effective therapy and sustaining the effectiveness of the current antifungal armamentarium.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 6