6533b82efe1ef96bd1293d3c
RESEARCH PRODUCT
MEDical wards Invasive Candidiasis ALgorithms (MEDICAL):Consensus proposal for management
Luigia ScudellerBassetti MatteoConcia ErcoleCorrao SalvatoreCristini FrancescoFrancesco G. De Rosa Valerio Del BonoEmanuele Durante-mangoniMarco FalconeMenichetti FrancescoTascini CarloTumbarello MarioVenditti MarioViale PierluigiViscoli ClaudioMazzone AntoninoGroup Medical Società Italiana Di Terapia Antinfettiva (Sita) Federazione Delle Associazioni Dei Dirigenti Ospedalieri Internisti (Fadoi)subject
0301 basic medicineMedical wardAntifungal AgentsConsensusInvasiveCritical CareDelphi TechniqueClinical severity; Invasive candidiasis; Medical wards; Risk stratification; Algorithms; Antifungal Agents; Candidiasis Invasive; Consensus; Critical Care; Delphi Technique; Early Diagnosis; Echinocandins; Humans; Internal Medicine; Italy; Practice Guidelines as Topic; Severity of Illness Index; Internal Medicine030106 microbiologyeducationDelphi methodInvasive candidiasiSettore MED/17 - MALATTIE INFETTIVESeverity of Illness Indexlaw.invention03 medical and health sciencesEchinocandins0302 clinical medicinelawIntensive careSeverity of illnessMedical consensusInternal MedicineMedicineHumansCandidiasis InvasiveClinical severity030212 general & internal medicineRisk stratificationcomputer.programming_languageClinical pharmacologybusiness.industryCandidiasisClinical severity; Invasive candidiasis; Medical wards; Risk stratificationInvasive candidiasismedicine.diseaseMedical wardsInvasive candidiasisEarly DiagnosisItalyInfectious disease (medical specialty)Practice Guidelines as TopicbusinessClinical severity; Invasive candidiasis; Medical wards; Risk stratification; Internal MedicinecomputerAlgorithmDelphiAlgorithmsdescription
Abstract Introduction A majority of invasive Candida infections occur in medical wards; however, evidence for management in this setting is scarce and based primarily on the intensive care or surgical setting. On behalf of the Italian Society for Anti-Infective Therapy (SITA) and the Italian Federation of Associations of Hospital Doctors on Internal Medicine (FADOI), the MEDICAL group produced practical management algorithms for patients in internal medicine wards. Methods The MEDICAL group panel, composed of 30 members from internal medicine, infectious disease, clinical pharmacology, clinical microbiology and clinical epidemiology, provided expert opinion through the RAND/UCLA method. Results Seven clinical scenarios were constructed based on clinical severity and probability of invasive candidiasis. For each scenario, the appropriateness of 63 different diagnostic, imaging, management, or therapeutic procedures was determined in two Delphi rounds. The necessity for performing each appropriate procedure, was then determined in a third Delphi round. Results were summarized in algorithms. Discussion The proposed algorithms provide internal medicine physicians and managers with an easy to interpret tool that is exhaustive, clear and suitable for adaption to individual local settings. Attention was paid to individual patient management and resource allocation.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2016-10-01 |