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Antifungal agents for preventing fungal infections in non-neutropenic critically-ill patients

  • Protocol
  • Intervention

Authors

  • EG Playford,

  • AC Webster,

  • TC Sorrell,

  • JC Craig


Dr Elliott Geoffrey Playford, Infectious Diseases Physician, Infection Management Services, Princess Alexandra Hospital, Ipswich Road, Woolloongabba, Queensland, 4102, AUSTRALIA. geoffrey_playford@health.qld.gov.au.

Abstract

This is the protocol for a review and there is no abstract. The objectives are as follows:

The objectives of this review will be to determine the benefits and harms of the prophylactic administration of antifungal agents in nonneutropenic critically-ill patients.

The following primary questions will be examined where sufficient data are available:

  • Is prophylaxis with any antifungal agent(s) associated with reduced proven invasive fungal infections and total mortality compared with no prophylaxis?

  • Are some agent(s) alone or in combination more efficacious than others?

  • For each agent, does the efficacy depend upon dose, route of administration, and duration of prophylaxis?

  • Do some patient subgroups (e.g. medical versus surgical) derive greater benefit from antifungal prophylaxis than others?

Secondary questions will be examined where sufficient data are available:

  • Is antifungal prophylaxis associated with reduced suspected invasive fungal infections?

  • Is antifungal prophylaxis associated with reduced superficial fungal infections?

  • Is antifungal prophylaxis associated with reduced fungal colonization?

  • Is antifungal prophylaxis associated with increased colonization or infection with azole-resistant fungal strains or species?

  • Is prophylaxis with antifungal agent(s) associated with clinically-significant toxicity?

  • Is antifungal prophylaxis a cost-effective strategy?

If there is insufficient data of adequate quality to address these questions, the lack of good evidence will be highlighted.