Abstract
Invasive candidiasis is associated with high mortality, particularly in adults. Retrospective studies show that shorter times to treatment are correlated with a lower risk of death. A number of factors can be used to predict which patients would benefit from antifungal prophylaxis or early (pre-emptive or empirical) therapy. Detection of the fungal cell wall component (1→3)-β-D-glucan (BDG) shows promise as an early biomarker of invasive fungal infection and may be useful in identifying patients who would benefit from early antifungal treatment. To date, no consistent early treatment strategy has evolved. Proof-of-concept studies are needed to assess the role of pre-emptive and empirical therapy in ICU patients and the relevance of BDG as an early marker of infection.
Acknowledgements
This manuscript summarizes the proceedings of a clinical advisory board on early antifungal therapy sponsored by Pfizer Inc. Editorial support was provided by D. Wolf, MSc, of PAREXEL, and was funded by Pfizer Inc.
Disclosures
Dr Ostrosky-Zeichner has received research grants and has been a consultant or speaker for the following companies: Pfizer, Merck, Astellas, Basilea, Gilead, and Associates of Cape Cod; Dr Kullberg has received research grants from Pfizer and has been a consultant or speaker for the following companies: Astellas, Basilea, and Pfizer; Dr Bow has received research grants and served as a consultant or speaker for the following companies: Pfizer, Merck-Frosst, Astellas, Amgen, Wyeth Pharmaceuticals, and Schering-Plough; Dr Hadley received research support, consulting fees or speaker honoraria from Pfizer, Schering-Plough, Merck and Astellas; Dr León has received research grants and has been a consultant or speaker for the following companies: Pfizer, Merck, Astellas, and Gilead; Dr Nucci has received research grants and has been a consultant or speaker for the following companies: Pfizer, Merck, Astellas, Gilead, and Bayer; Dr Patterson has received research grants to the University of Texas Health Science Center at San Antonio from Basilea, Merck, Pfizer, and Schering-Plough, and consulting fees or honoraria from Basilea and Pfizer; Dr Perfect has received research support, consulting fees, and honoraria from Pfizer, Schering-Plough, Merck, Astellas, Enzon, and Basilea.
This paper was first published online on Early Online on 7 September 2010.