The use of topical nonabsorbable gastrointestinal antifungal prophylaxis to prevent fungal infections in critically ill immunocompetent patients: A meta-analysis

Abstract

In critically ill immunocompetent patients who are at high risk of fungal infection, topical nonabsorbable gastrointestinal antifungal prophylaxis was associated with a reduced incidence of urinary fungal infections and a trend toward reduction in respiratory fungal infections and fungemia. Limitations in study data are such that many of these infections may have represented superficial infections of uncertain clinical importance; a large, randomized, controlled trial is needed to assess the cost-effectiveness and safety of topical nonabsorbable antifungal prophylaxis in critically ill patients.

Single-drug therapy or selective decontamination of the digestive tract as antifungal prophylaxis in critically ill patients: a systematic review

“…The results of this review generally confirm the conclusions of earlier reviews examining the separate effects on yeast infections of SDD [ 30 , 32 ] or SAP [ 33 - 35 ]. However, these reviews have some shortcomings.…”

Value of anti-infective chemoprophylaxis in primary systemic vasculitis: what is the evidence?

“…In critically ill patients and solid organ transplant recipients prophylaxis using fluconazole is effective in avoiding invasive candidiasis [73,74]. Using topical non-absorbable antifungal prophylaxis in immunocompetent critically ill patients leads also to a significant reduction in fungal (mainly non-invasive) infections [75]. According to the BSR, prophylaxis with nystatin, amphotericin or fluconazole should be considered in all AAV patients receiving high-dose immunosuppressive therapy [57].…”

Role of oral nystatin prophylaxis in cardiac surgery with prolongedextracorporeal circulation

“…Moreover, no adverse effects of nystatin are reported and its low‐cost makes the use highly cost‐effective . A meta‐analysis of Ho et al on critically ill patients demonstrated a significant reduction in urinary tract fungal infections, and 2 other works considered the risk of Candida infection, with and without nystatin prophylaxis, in very low birth weight infants and patients with burn injury . Giglio and coworkers showed that nystatin prophylaxis significantly reduces fungal colonisation in surgical/trauma ICU patients, even if already colonised, since colonisation can be observed on admission in up to 50% of ICU patients …”