https://scholars.lib.ntu.edu.tw/handle/123456789/532735
標題: | 2016 guideline strategies for the use of antifungal agents in patients with hematological malignancies or hematopoietic stem cell transplantation recipients in Taiwan | 作者: | BOR-SHENG KO Chen W.-T. HSIANG-CHI KUNG UN-IN WU JIH-LUH TANG MING YAO YEE-CHUN CHEN HWEI-FANG TIEN SHAN-CHWEN CHANG Chuang Y.-C. Lin D.-T. The Infectious Diseases Society of Taiwan, The Hematology Society of Taiwan, The Taiwan Society of Blood Marrow Transplantation, Medical Foundation in Memory of Dr Deh-Lin Cheng, Foundation of Professor Wei-Chuan Hsieh for Infectious Diseases Research Education, CY Lee's Research Foundation for Pediatric Infectious Diseases Vaccines |
公開日期: | 2018 | 出版社: | Elsevier Ltd | 卷: | 51 | 期: | 3 | 起(迄)頁: | 287-301 | 來源出版物: | Journal of Microbiology, Immunology and Infection | 摘要: | The Infectious Diseases Society of Taiwan (IDST), the Hematology Society of Taiwan, the Taiwan Society of Blood and Marrow Transplantation, Medical Foundation in Memory of Dr. Deh-Lin Cheng, Foundation of Professor Wei-Chuan Hsieh for Infectious Diseases Research and Education, and CY Lee's Research Foundation for Pediatric Infectious Diseases and Vaccines cooperatively published this guideline for the use of antifungal agents in hematological patients with invasive fungal diseases (IFDs) in Taiwan. The guideline is the first one endorsed by IDST focusing on selection of antifungal strategies, including prophylaxis, empirical (or symptom-driven) and pre-emptive (or diagnostic-driven) strategy. We suggest a risk-adapted dynamic strategy and provide an algorithm to facilitate decision making in population level as well as for individual patient. Risk assessment and management accordingly is explicitly emphasized. In addition, we highlight the importance of diagnosis in each antifungal strategy among five elements of the antimicrobial stewardship (diagnosis, drug, dose, de-escalation and duration). The rationale, purpose, and key recommendations for the choice of antifungal strategy are summarized, with concise review of international guidelines or recommendation, key original articles and local epidemiology reports. We point out the interaction and influence between elements of recommendations and limitation of and gap between evidences and daily practice. The guideline balances the quality of evidence and feasibility of recommendation in clinical practice. Finally, this version introduces the concept of health economics and provides data translated from local disease burdens. All these contents hopefully facilitate transparency and accountability in medical decision-making, improvements in clinical care and health outcomes, and appropriateness of medical resource allocation. ? 2017 |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85026765228&doi=10.1016%2fj.jmii.2017.07.005&partnerID=40&md5=210d5ab7b19c1ad22c8315bb8ef9aecc https://scholars.lib.ntu.edu.tw/handle/123456789/532735 |
ISSN: | 1684-1182 | DOI: | 10.1016/j.jmii.2017.07.005 | SDG/關鍵字: | antifungal agent; antifungal agent; antimicrobial stewardship; clinical practice; disease burden; graft recipient; health economics; hematologic malignancy; hematopoietic stem cell transplantation; human; practice guideline; Review; risk assessment; risk management; Taiwan; algorithm; antibiotic prophylaxis; clinical decision making; economics; health care delivery; hematologic disease; hematopoietic stem cell transplantation; microbiology; standards; systemic mycosis; Algorithms; Antibiotic Prophylaxis; Antifungal Agents; Antimicrobial Stewardship; Clinical Decision-Making; Delivery of Health Care; Guidelines as Topic; Hematologic Neoplasms; Hematopoietic Stem Cell Transplantation; Humans; Invasive Fungal Infections; Risk Assessment; Taiwan |
顯示於: | 醫學系 |
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