MEDical wards Invasive Candidiasis ALgorithms (MEDICAL):Consensus proposal for management

Area of Science:

• Infectious Diseases
• Internal Medicine
• Clinical Management

Background:

• Invasive Candida infections frequently occur in internal medicine wards, yet specific management guidelines for this setting are limited.
• Existing evidence for invasive candidiasis management is primarily derived from intensive care or surgical contexts.
• This study addresses the need for evidence-based guidance tailored to internal medicine patients.

Purpose of the Study:

• To create practical, evidence-based management algorithms for invasive Candida infections in internal medicine wards.
• To provide a clear and adaptable tool for physicians and healthcare managers.
• To optimize patient care and resource allocation in the management of invasive candidiasis.

Main Methods:

• Expert consensus was achieved using the RAND/UCLA methodology involving a multidisciplinary panel of 30 specialists.
• Seven clinical scenarios were developed based on disease severity and likelihood of invasive candidiasis.
• Three Delphi rounds were conducted to determine the appropriateness and necessity of diagnostic and therapeutic procedures.

Main Results:

• Algorithms were generated, summarizing the appropriateness and necessity of 63 different procedures across seven clinical scenarios.
• The developed algorithms offer a structured approach to managing invasive candidiasis in internal medicine.
• The findings provide a framework for consistent and effective patient care.

Conclusions:

• The proposed algorithms serve as an easily interpretable tool for internal medicine physicians and managers.
• These algorithms are designed to be comprehensive, clear, and adaptable to local healthcare settings.
• The tool emphasizes individualized patient management and efficient resource allocation for invasive candidiasis.