Current opinion in infectious diseases
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Curr. Opin. Infect. Dis. · Dec 2004
ReviewImpact of real-time fungal susceptibility on clinical practices.
In the past two decades standardized in-vitro antifungal susceptibility tests have been developed in response to increasing invasive fungal infections. Our purpose is to review the utility of real-time Candida antifungal susceptibility testing and its effects on clinical outcomes in the context of the new antifungal agents, existing antifungal susceptibility testing methods, and the changing epidemiology and susceptibilities of Candida spp. ⋯ Newer antifungal agents with broader anti-Candida activity, fewer adverse events and minimal resistance are currently available. The challenge clinicians face is choosing when to use these agents appropriately, while considering the changing Candida epidemiology and susceptibility trends without over-treating fluconazole-sensitive pathogens. Unfortunately, the correlation of antifungal susceptibility testing results by any method and clinical outcome is mostly lacking. We suggest that a concerted examination of the utility of real-time antifungal susceptibility testing and its effect on clinical outcomes by guiding appropriate antifungal therapy for high-risk patients with invasive candidiasis is warranted.