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Review
. 2023 Aug 30;15(8):e44356.
doi: 10.7759/cureus.44356. eCollection 2023 Aug.

Challenges in the Management of Invasive Fungal Infections in the Middle East: Expert Opinion to Optimize Management Using a Multidisciplinary Approach

Reem S AlMaghrabi  1 , Tariq Al-Musawi  2   3 , Osama Albaksami  4 , Ahmad L Subhi  5 , Riad E Fakih  6   7 , Neil R Stone  8   9
Affiliations
Review

Challenges in the Management of Invasive Fungal Infections in the Middle East: Expert Opinion to Optimize Management Using a Multidisciplinary Approach

Reem S AlMaghrabi et al. Cureus. .

Abstract

Invasive fungal infection (IFI) is a significant global healthcare concern among critically ill and immunocompromised patients. In Middle Eastern countries, IFI has been steadily increasing among hospitalized patients in the past two decades. Diagnosis of IFI at an early stage is crucial for efficient management. Invasive fungal infection management is complex and requires the involvement of physicians from different specialties. There are several challenges associated with IFI management in the countries in the Middle East. This review aims to understand the key challenges associated with IFI management in the Middle East, encompassing epidemiology, diagnosis, therapeutic options, and optimizing a multidisciplinary approach. In addition, this review aims to incorporate expert opinions from multidisciplinary fields for optimizing IFI management in different Middle Eastern countries by addressing key decision points throughout the patient's journey. Lack of epidemiological data on fungal infections, slow and poorly sensitive conventional culture-based diagnostic tests, limited availability of biomarker testing, lack of awareness of clinical symptoms of the disease, limited knowledge on fungal infections, lack of local practice guidelines, and complicated disease management are the major challenges associated with IFI diagnosis and management in the Middle Eastern countries. Implementation of a multidisciplinary approach, antifungal stewardship, improved knowledge of fungal infections, the use of rapid diagnostic tests, and enhanced epidemiological research are warranted to lower the IFI burden in the Middle East.

Keywords: antifungal treatment; epidemiology; invasive fungal infections; middle east; multidisciplinary team.

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Conflict of interest statement

The authors have declared financial relationships, which are detailed in the next section.

Figures

Figure 1
Figure 1. An MDT Approach in IFI management
Adapted from [50] DDI: drug-drug interactions; IFI: invasive fungal infection; MDT: multidisciplinary approach; TDM: therapeutic drug monitoring
Figure 2
Figure 2. Expert recommendations for IFI management in the Middle East
Image created by the authors. AFS: antifungal stewardship; ASP: antifungal stewardship program; HCPs: healthcare professionals; IFI: invasive fungal infections; MALDI-TOF: matrix-assisted laser desorption/ionization time of flight; PCR: polymerase chain reaction; TDM: therapeutic drug monitoring
See this image and copyright information in PMC

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