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Related Concept Videos

Antifungal Agents01:15

Antifungal Agents

119
Amphotericin B is a broad-spectrum antifungal agent that exploits structural differences between fungal and mammalian cell membranes. Its amphipathic structure—featuring a hydrophobic polyene-lactone ring and a hydrophilic region containing mycosamine and carboxylic acid groups—enables selective binding to ergosterol, a sterol predominantly found in fungal plasma membranes. This selective interaction underlies the drug’s antifungal activity, although weak binding to...
119

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Related Experiment Video

Updated: Apr 29, 2026

Whole Genome Sequencing of Candida glabrata for Detection of Markers of Antifungal Drug Resistance
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Whole Genome Sequencing of Candida glabrata for Detection of Markers of Antifungal Drug Resistance

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Our 2014 approach to candidaemia.

Philipp Koehler1, Daniela Tacke, Oliver A Cornely

  • 1Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany; CECAD - Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases, University of Cologne, Cologne, Germany.

Mycoses
|May 28, 2014
PubMed
Summary

Prompt management of candidaemia (bloodstream fungal infections) is crucial for reducing mortality. This algorithm outlines immediate treatment with echinocandins, catheter removal, and tailored therapy for Candida parapsilosis to improve patient outcomes.

Keywords:
C. albicansC. glabrataC. parapsilosisechinocandinfluconazoleliposomal amphotericin B

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Area of Science:

  • Infectious Diseases
  • Critical Care Medicine
  • Mycology

Background:

  • Candidaemia presents a significant clinical challenge, particularly in intensive care settings.
  • Delayed treatment of bloodstream fungal infections directly correlates with increased mortality rates.
  • Standardized institutional protocols are essential for effective patient management.

Purpose of the Study:

  • To present an institutional management algorithm for candidaemia.
  • To align patient care with current guidelines and recommendations for improved outcomes.
  • To provide a clear, actionable strategy for healthcare professionals managing fungal blood infections.

Main Methods:

  • Immediate initiation of antifungal therapy, prioritizing echinocandins.
  • Removal of indwelling catheters when clinically feasible.
  • Daily blood cultures to monitor treatment efficacy and confirm clearance of fungaemia.

Main Results:

  • The algorithm emphasizes prompt treatment to mitigate mortality risks.
  • Specific guidance is provided for Candida parapsilosis, recommending a switch to fluconazole.
  • A simplified step-down therapy approach using oral fluconazole after 10 days of intravenous treatment is outlined.

Conclusions:

  • Adherence to a structured management algorithm improves patient outcomes in candidaemia.
  • Antifungal treatment duration should extend at least 14 days post-negative blood culture, adjusted for clinical factors.
  • The presented algorithm serves as a practical tool for optimizing candidaemia care in clinical practice.