RASCANDIS 1.0 Form: Therapeutic Approach of Systemic Anti-Candidiasis for Non-Transplant Patients

Abstract

Abstract

It has been a concern that the use of antifungal may induce some fungi to develop antifungal resistance in the future. Therefore, the use of antifungal medication must be controlled so that it can be used appropriately. The use of systemic anti-candidiasis agents should become a focus in controlling antifungal drugs considering that it is quite commonly used. Systemic anti-candidiasis is generally aimed for those with infection cases or those who are at very high risk for developing invasive candidiasis. It can be manifested as candidemia or deep organ infection of Candida sp. There are currently three approaches of using systemic anti-candidiasis agents based on its indication, i.e. definitive, empiric and pre-emptive indication, in which can be applied by observing supportive findings such as the presence of Candida sp infection or colonization, severity of infection and patient’s risk factors. The severity of invasive candidiasis is usually severe and there are various risk factors that need to be taken into consideration such as the use of Total Parenteral Nutrition (TPN), catheterization including deep vein catheter, central venous catheter (CVC), etc. 

Antifungal stewardship program, including the management of using systemic anti-candidiasis, is essential nowadays. It is necessary to have a program that can serve as a guideline for clinicians to implement treatment approach of systemic anti-candidiasis. RASPRO Alur Anti Candida Sistemik (RASCANDIS) 1.0 form or the Indonesian Regulation on the Prospective Antimicrobial System on Systemic Anti-Candidiasis Flowchart 1.0 form is an actual implementation to provide guideline for clinicians to administer systemic anti-candidiasis agents for non-transplant patients. The form is not a diagnostic tool, but it is more likely serves a review and summary of knowledge obtained from various scientific journals, which is expected that it can be proposed as an effort to administer therapeutic management of systemic anti-candidiasis appropriately.

Keywords: systemic anti-candidiasis, non-transplant, RASCANDIS 1.0, appropriately