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Treatment of invasive candidiasis in the elderly: a review

Authors Flevari A, Theodorakopoulou M, Velegraki A, Armaganidis A, Dimopoulos G

Received 9 May 2013

Accepted for publication 29 May 2013

Published 9 September 2013 Volume 2013:8 Pages 1199—1208

DOI https://doi.org/10.2147/CIA.S39120

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Aikaterini Flevari,1 Maria Theodorakopoulou,1 Aristea Velegraki,2 Apostolos Armaganidis,1 George Dimopoulos1

1Department of Critical Care, University Hospital Attikon, Medical School, 2Mycology Laboratory, Department of Microbiology, Medical School, University of Athens, Athens, Greece

Abstract: Fungi are major causes of infections among immunocompromised or hospitalized patients with serious underlying diseases and comorbidities. Candida species remain the most important cause of opportunistic infections worldwide, affecting predominantly patients over 65 years old, while they are considered to be the fourth most common cause of nosocomial bloodstream infections. The rapidly growing elderly population has specific physiological characteristics, which makes it susceptible to colonization and subsequent infection due to Candida species. Comorbidities and multidrug use should be taken into account any time the therapeutic regimen is under consideration. Different classes of antifungal drugs are available for the treatment of invasive fungal infections but echinocandins, apart from their activity against resistant strains (Candida glabrata and Candida krusei), seem to be safe, with limited adverse events and minimal drug–drug interactions in comparison to the other regimens. Therefore, these agents are strongly recommended when dealing with elderly patients suffering from an invasive form of Candida infection.

Keywords: emerging fungal infections, elderly patients, treatment

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