从2012年ESCMID到2025年全球ECMM/ISHAM/ASM候选指南:主要差异和实际影响是什么?
1Institute of Hygiene and Medical Microbiology, ECMM Excellent Center of Mycology, Medical University of Innsbruck, Innsbruck, Austria.
Revista iberoamericana de micologia
|July 9, 2025
概括
2025年全球Candida指导方针统一了侵袭性角膜炎的治疗方法,优先考虑类和个性化治疗的新药. 它强调管理耐药性和根据当地流行病学和患者需求量身定制策略.
科学领域:
- 医学真菌学 医学真菌学
- 传染性疾病 传染性疾病
- 临床指南 临床指南
背景情况:
- 之前的指导方针要求查阅多个文件,以进行侵入性角膜炎的治疗.
- 2012年的指导方针缺乏对新出现的耐药性和较新的抗真菌剂的全面覆盖.
研究的目的:
- 提出一个统一的,全面的全球指导方针,用于侵袭性角膜病的管理.
- 将最近的抗真菌疗法的进展纳入其中,并应对抗药性等新出现的挑战.
主要方法:
- 使用GRADE系统开发基于证据的评级建议.
- 包括关于新出现的病原体,抗真菌管理和感染控制的部分.
- 考虑公共卫生和资源有限的环境.
主要成果:
- 埃奇诺坎丁仍然是第一线药物;新的药物 (雷扎金,新型口服药) 提供个性化,以敏感性为导向的治疗.
- 建议在稳定的非中性衰竭患者中提前降低IV至口服,并强调源控制.
- 解决新出现的耐药性 (例如,Candida auris,耐醇Candida parapsilosis) 和量身定制的策略.
结论:
- 全球Candida 2025指南为从业者提供了一个单一文档资源.
- 它通过更新的治疗选择和专注于耐药性和流行病学来增强侵入性角膜炎的管理.
- 该指南促进全球个性化治疗,抗真菌管理和感染控制.
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