Invasive candidosis: contrasting the perceptions of infectious disease physicians and intensive care physicians
Rev. Soc. Bras. Med. Trop
;
46(4): 466-471, Jul-Aug/2013. tab
Article
Dans Anglais
| LILACS
| ID: lil-683324
ABSTRACT
Introduction We analyze how infectious disease physicians perceive and manage invasive candidosis in Brazil, in comparison to intensive care unit specialists. Methods A 38-question survey was administered to 56 participants. Questions involved clinicians' perceptions of the epidemiology, diagnosis, treatment and prophylaxis of invasive candidosis. P < 0.05 was considered statistically significant. Results The perception that candidemia not caused by Candida albicans occurs in less than 10% of patients is more commonly held by intensive care unit specialists (p=0.018). Infectious disease physicians almost always use antifungal drugs in the treatment of patients with candidemia, and antifungal drugs are not as frequently prescribed by intensive care unit specialists (p=0.006). Infectious disease physicians often do not use voriconazole when a patient's antifungal treatment has failed with fluconazole, which also differs from the behavior of intensive care unit specialists (p=0.019). Many intensive care unit specialists use fluconazole to treat candidemia in neutropenic patients previously exposed to fluconazole, in contrast to infectious disease physicians (p=0.024). Infectious disease physicians prefer echinocandins as a first choice in the treatment of unstable neutropenic patients more frequently than intensive care unit specialists (p=0.013). When candidemia is diagnosed, most infectious disease physicians perform fundoscopy (p=0.015), whereas intensive care unit specialists usually perform echocardiograms on all patients (p=0.054). Conclusions This study reveals a need to better educate physicians in Brazil regarding invasive candidosis. The appropriate management of this disease depends on more drug options being available in our country in addition to global coverage in private and public hospitals, thereby improving health care. .
Texte intégral:
Disponible
Indice:
LILAS (Amériques)
Sujet Principal:
Types de pratiques des médecins
/
Compétence clinique
/
Soins de réanimation
/
Infectiologie
/
Candidose invasive
Type d'étude:
Essai clinique contrôlé
/
Étude pronostique
Limites du sujet:
Humains
langue:
Anglais
Texte intégral:
Rev. Soc. Bras. Med. Trop
Thème du journal:
Médecine tropicale
Année:
2013
Type:
Article
Pays d'affiliation:
Brésil
Institution/Pays d'affiliation:
Santa Casa Complexo Hospitalar/BR
Documents relatifs à ce sujet
MEDLINE
...
LILACS
LIS