https://scholars.lib.ntu.edu.tw/handle/123456789/510022
標題: | Clinicians’ challenges in managing patients with invasive fungal diseases in seven Asian countries: An Asia Fungal Working Group (AFWG) Survey | 作者: | Tan, Ban Hock Chakrabarti, Arunaloke Patel, Atul Chua, Mitzi Marie M. Sun, Pei Lun Liu, Zhengyin Rotjanapan, Porpon Li, Ruoyu Wahyuningsih, Retno Chayakulkeeree, Methee YEE-CHUN CHEN |
關鍵字: | Antifungal management strategies | Education | Mycology practice | Treatment guidelines;Antifungal management strategies; Education; Mycology practice; Treatment guidelines | 公開日期: | 1-一月-2020 | 出版社: | ELSEVIER SCI LTD | 卷: | 95 | 起(迄)頁: | 471 | 來源出版物: | International Journal of Infectious Diseases | 摘要: | © 2020 The Authors Background: Invasive fungal diseases (IFD) are a serious threat, but physicians in Asia lack access to many advanced diagnostics in mycology. It is likely that they face other impediments in the management of IFD. A gap analysis was performed to understand the challenges Asian physicians faced in medical mycology. Methods: The Asia Fungal Working Group (AFWG) conducted a web-based survey on management practices for IFD among clinicians in China, India, Indonesia, Philippines, Singapore, Taiwan and Thailand. Findings: Among 292 respondents, 51.7% were infectious disease (ID) specialists. Only 37% of respondents had received formal training in medical mycology. They handled only around 2–4 proven cases of each fungal infection monthly, with invasive candidiasis the most common. For laboratory support, the majority had access to direct microscopy (96%) and histopathology (87%), but galactomannan and azole levels were available to 60% and 25% of respondents, respectively. The majority (84%) used clinical parameters for treatment response monitoring, and 77% followed the Infectious Diseases Society of America guidelines. The majority (84%) did not use the services of an ID physician. Where febrile neutropenia was concerned, 74% of respondents used the empirical approach. Only 30% had an antifungal stewardship program in their hospital. Eighty percent could not use preferred antifungals because of cost. Interpretation: The survey identified inadequacies in medical mycology training, non-culture diagnostics, access to antifungal drugs, and local guidelines as the major gaps in the management of IFDs in Asian countries. These gaps are targets for improvement. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/510022 | ISSN: | 12019712 | DOI: | 10.1016/j.ijid.2020.01.007 | SDG/關鍵字: | antifungal agent; galactomannan; pyrrole; antifungal agent; mannan; antimicrobial stewardship; Article; Asia; China; clinical practice; drug cost; febrile neutropenia; health care access; health care survey; histopathology; human; India; Indonesia; invasive candidiasis; medical education; microscopy; Philippines; physician; practice guideline; Singapore; systemic mycosis; Taiwan; Thailand; treatment response; clinical competence; education; invasive candidiasis; metabolism; mycology; questionnaire; systemic mycosis; Antifungal Agents; Candidiasis, Invasive; China; Clinical Competence; Education, Medical; Humans; India; Indonesia; Invasive Fungal Infections; Mannans; Mycology; Philippines; Singapore; Surveys and Questionnaires; Taiwan; Thailand |
顯示於: | 醫學院附設醫院 (臺大醫院) |
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