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EQUAL Candida Score: An ECMM score derived from current guidelines to measure QUAlity of Clinical Candidaemia Management
Author(s) -
Mellinghoff Sibylle C.,
Hoenigl Martin,
Koehler Philipp,
Kumar Anil,
Lagrou Katrien,
LassFlörl Cornelia,
Meis Jacques F.,
Me Vidya,
RautemaaRichardson Riina,
Cornely Oliver A.
Publication year - 2018
Publication title -
mycoses
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.13
H-Index - 69
eISSN - 1439-0507
pISSN - 0933-7407
DOI - 10.1111/myc.12746
Subject(s) - guideline , intensive care medicine , antifungal , fluconazole , medicine , echinocandin , clinical microbiology , candida infections , pathology , biology , microbiology and biotechnology , dermatology
Summary Candida species frequently cause blood stream infections and are reported to be the third to tenth most commonly isolated pathogens. Guidelines and standardised treatment algorithms provided by professional organisations aim to facilitate decision‐making regarding diagnosis, management and treatment of candidaemia. In routine clinical practise, however, it may be challenging to comply with these guidelines. The reasons include lack of familiarity or feasibility to adherence, but also their length and complexity. There is no tool to measure guideline adherence currently. To provide such a tool, we reviewed the current guidelines provided by the European Society for Clinical Microbiology and Infectious Diseases ( ESCMID ) and by the Infectious Diseases Society of America ( IDSA ) , and selected the strongest recommendations for management quality as the bases for our scoring tool. Factors incorporated were diagnostic (blood cultures, echocardiography, ophthalmoscopy, species identification) and follow‐up procedures (repeat blood cultures until negative result) as well as key treatment parameters (echinocandin treatment, step down to fluconazole depending on susceptibility result, CVC removal). The EQUAL Candida Score weighs and aggregates factors recommended for the ideal management of candidaemia and provides a tool for antifungal stewardship as well as for measuring guideline adherence.