在重症监护病房患者的抗真菌治疗策略
Claudia Bartalucci1, Laura Mezzogori1,2, Riccardo Schiavoni1,2
1Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.
European journal of clinical investigation
|January 22, 2026
概括
在重症患者中优化侵袭性真菌感染的抗真菌治疗至关重要. 本综述涵盖了当前的疗法,新药,以及对 кандидоз,阿斯伯吉洛斯和肺囊肺炎的诊断挑战.
科学领域:
- 关键护理医学 关键护理医学
- 传染性疾病 传染性疾病
- 菌类学 菌类学是指菌类学.
背景情况:
- 侵入性真菌感染 (IFI) 在重症患者中显著增加了发病率和死亡率.
- 侵袭性候群病 (IC),侵袭性肺阿斯伯吉洛症 (IPA) 和Pneumocystis jirovecii肺炎 (PjP) 在重症监护病房 (ICU) 普遍存在.
- 由于非特异性症状,延迟培养和不可靠的生物标志物,诊断具有挑战性,使治疗决策复杂化.
研究的目的:
- 在重症患者中审查IC,IPA和PjP的当前治疗策略.
- 讨论基于证据的建议和抗真菌治疗的最新进展.
- 探索药理动力学/药理动力学方面的考虑,药物监测和新型抗真菌剂.
主要方法:
- 在ICU环境中对IC,IPA和PjP的治疗方法进行全面的文献综述.
- 分析当前基于证据的指导方针和新兴研究.
- 讨论PK/PD原则,治疗药物监测和新的抗真菌药物.
主要成果:
- 埃奇诺坎丁是IC的主要成分;生物标志物比启动更有助于停止治疗.
- 沃里康纳和伊萨武康纳是IPA的第一线治疗;脂质体安二B是抗醇病例的替代方案.
- trimethoprim-sulfamethoxazole是PjP的标准;皮质类固醇有益于严重疾病的HIV患者. 新手代理商看起来很有前途.
结论:
- 个性化抗真菌治疗和早期诊断是改善结果的关键.
- 抗真菌管理对于管理高风险的ICU人群中的IFI至关重要.
- 对新药和诊断工具的持续研究将提高治疗效率.
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