Invazinės kandidozės, aspergiliozės ir mukormikozės ECIL-6 gydymo gairės, skirtos KKLT ir leukemija sergantiems pacientams Roberta Petrauskaitė
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1 Invazinės kandidozės, aspergiliozės ir mukormikozės ECIL-6 gydymo gairės, skirtos KKLT ir leukemija sergantiems pacientams Roberta Petrauskaitė Wednesday, April 19, 2017
2 Planas Candida ir aspergillus infekcijų gydymo rekomendacijų klasifikavimas Pirmos eilės invazinės kandidozės gydymo tyrimai, rekomendacijos Kandidemijos gydymo rekomendacijos, identifikavus rūšį Pirmos eilės invazinės aspergiliozės gydymo tyrimai, rekomendacijos Invazinės aspergiliozės gelbstinčio gydymo rekomendacijos Pirmos eilės mukormikozių gydymo rekomendacijos Mukormikozių gelbstinčio ir palaikomojo gydymo rekomendacijos Wednesday, April 19, 2017
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5 Pirmos eilės invazinės kandidozės gydymo tyrimai
6 d-amb and d-amb in survival rates better tolerated Mora-Duarte, Caspofungin Caspofungin Similar survival Less clinical and d-amb not inferior to d-amb and relapse rate laboratory drug-related adverse events with caspofungin Rex, Fluconazole Improved success rate Similar time Fluconazole Fluconazole + d-amb for the combination to failure and survival; monotherapy better therapy higher rate of blood tolerated than culture clearance with combination therapy combination DiNubile, Voriconazole d-amb then fluconazole Voriconazole not inferior to d-amb/fluconazole Similar survival and time to clear blood Less all-cause adverse events in patients cultures receiving voriconazole receiving voriconazole Kullberg, Caspofungin Similar for Response Caspofungin d-amb caspofungin and rate lower in better tolerated d-amb neutropenic than in than non-neutropenic cancer pts d-amb Ostrosky-Zeichner, Micafungin High success rate High success rate No unexpected Micafungin + other agent for first-line and salvage therapy in neutropenic pts adverse event Kuse, 2007 Anidulafungin Higher response Similar 6-week survival; More drug-related elevation
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10 ECIL - 6 pirmos eilės kandidemijos gydymo rekomendacijos Wednesday, April 19, 2017
11 ECIL - 6 kandidemijos gydymo rekomendacijos, identifikavus rūšį Wednesday, April 19, 2017
12 Pirmos eilės invazinės aspergiliozės gydymo tyrimai (I)
13 Pirmos eilės invazinės aspergiliozės gydymo tyrimai (II)
14 ECIL - 6 pirmos eilės invazinės aspergiliozės gydymo rekomendacijos Wednesday, April 19, 2017
15 ECIL - 6 aspergiliozės gelbstinčio gydymo rekomendacijos Table 8. ECIL-6 recommendations for salvage therapy of invasive aspergillosis. Grade Comments Liposomal amphotericin B B II No data on voriconazole failure Amphotericin B lipid complex B II No data on voriconazole failure Caspofungin B II No data on voriconazole failure Itraconazole C III Insufficient data Posaconazole a B II No data on voriconazole failure Voriconazole a B II If not used in first-line Combination B II Various studies and conflicting results a Monitoring of serum levels is indicated, especially if posaconazole oral suspension is used. Wednesday, April 19, 2017
16 ECIL - 6 pirmos eilės mukormikozių gydymo rekomendacijos Wednesday, April 19, 2017
17 ECIL - 6 mukormikozių gelbstinčio ir palaikomojo gydymo rekomendacijos Wednesday, April 19, 2017
18 Išvados Kandidemijos pirmos eilės gydymui - echinokandinai. Anidulafunginas tinkamas kaip ir kiti echinokandinai onkohematologiniams pacientams. Sustiprinta kateterio pašalinimo rekomendacijos efektyvumas. Aspergiliozės pirmos eilės gydymui rekomenduojama vorikonazolis arba isavukonazolis. Wednesday, April 19, 2017
19 Geros dienos!
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