Leberfunktionsst?rungen in der Intensivmedizin

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• 作者：Ali E. Canbay ; Dr. Andreas Gl?ckner
• 关键词：Leberfunktionsst?rung ; Intensivtherapie ; Anidulafungin ; Invasive Candidainfektion ; Candid?mie ; Liver dysfunction ; Intensive care ; Anidulafungin ; Candidiasis ; invasive ; Candidemia
• 刊名：Wiener klinisches Magazin
• 出版年：2015
• 出版时间：October 2015
• 年：2015
• 卷：18
• 期：5
• 页码：174-181
• 全文大小：490 KB
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• 作者单位：Ali E. Canbay (1)
  Dr. Andreas Gl?ckner (2)
  
  1. Universit?tsklinikum Essen, Essen, Deutschland
  2. BDH Klinik Greifswald, Karl-Liebknecht-Ring 26a, D-17491, Greifswald, Deutschland
  
• 刊物主题：Medicine/Public Health, general;
• 出版者：Springer Vienna
• ISSN：1613-7817

文摘

Liver dysfunction is common among patients on intensive care units (ICU) due to sepsis, chronic liver disease, ischemic hepatitis, drug toxicity and intensive care measures. Critically ill patients with invasive fungal infections should therefore be treated with antifungals that are not metabolized by the liver. This may help to avoid therapeutic complications by drug accumulation, inadequate dosages or drug-drug interactions. Echinocandins are established as the antifungal class of choice in the treatment of invasive Candida infections. Anidulafungin is not hepatically metabolized and may be used without dose adjustments in patients with severe liver dysfunction. It has no known clinically relevant drug interactions. In the primary endpoint of the randomized pivotal trial in patients with candidemia or invasive candidiasis, anidulafungin was statistically superior versus the former standard therapy (fluconazole), with a favourable overall safety profile. More recent study data particularly in ICU patients confirm the efficacy of anidulafungin for these patient groups. Therefore, anidulafungin is an important antifungal treatment option for patients with liver dysfunction. Keywords Liver dysfunction Intensive care Anidulafungin Candidiasis, invasive Candidemia