Management of Intra-Abdominal Candidiasis in Intensive Care Setting. A Narrative Review

Complicated intra-abdominal infections are a major cause of sepsis-related mortality, with intra-abdominal candidiasis (IAC) as a knowing cause. Patients in intensive care units (ICU) are at the highest risk of invasive candidiasis and treatment focuses on intra-abdominal source control and appropriate antimicrobial therapy to reduce mortality. The management of complicated intraabdominal infection is a complex scenario where other conditions, beyond antifungal treatment, play a significant role. The patient's specific conditions, as well as early and proper control of the source of infection, are key factors in determining the outcome for these patients. However, despite prevention, advancements in diagnosis and treatment, mortality rates remain high up to 60%. This review provides updates on key concepts regarding the epidemiology and impact of Candida spp. in the peritoneal cavity, as well as risk factors for managing patients with intra-abdominal complications. Finally, it discusses antifungal treatment strategies based on pharmacokinetic/pharmacodynamic (PK/PD) parameters.