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Las infecciones fúngicas invasoras más frecuentes en pacientes críticos son las candidiasis invasivas (CI), entre las que se encuentra la candidemia. En los últimos años, se ha incrementado el porcentaje de estas infecciones en unidades de cuidados intensivos (UCI), con especies distintas de Candida albicans. Este hecho puede conllevar la aparición de especies resistentes a los antifúngicos. Para iniciar el tratamiento más adecuado, se necesita diagnosticar precozmente la infección, con lo que se disminuirían los tratamientos antibióticos empíricos y aumentaría la proporción de la terapia anticipada o dirigida. Ante la escasa fiabilidad de las técnicas diagnósticas disponibles, se están aplicando nuevas estrategias actualmente en la UCI, como el uso de scores para evaluar la presencia de la infección fúngica. El arsenal terapéutico se ha ampliado y la introducción de anidulafungina ha aportado un fármaco con características muy adecuadas para el tratamiento de la CI en pacientes críticos no inmunodeprimidos.
Palabras clave:
Candidiasis invasora
Terapia antifúngica empírica y anticipada
The most frequent invasive fungal infections in critically ill patients are invasive candidiasis, among which is candidemia. In the last few years, these infections have become more common in intensive care units (ICU), including those produced by species other than Candida albicans. This phenomenon may lead to the development of species resistant to antifungal agents. To start the most appropriate treatment, early diagnosis of the infection is essential, which would reduce empirical antibiotic treatment and increase the proportion of advanced or directed antibiotic therapy. Given the poor reliability of the available diagnostic techniques, new strategies are currently being employed in the ICU, such as the use of scores to evaluate the presence of fungal infections. The therapeutic arsenal against these infections has been increased and the introduction of anidulafungin represents the addition of a highly appropriate drug for the treatment of invasive candidiasis in immunocompetent critically ill patients.
Key words:
Invasive candidiasis
Empirical and preemptive antifungal therapy
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