Review on the management of intra-abdominal candidiasis.

Intra-abdominal candidiasis, which includes Candida peritonitis and Candida produced intra-abdominal abscesses, accounts for 10-30% of all intra-abdominal infections diagnosed in the intensive care units. Intra-abdominal candidiasis is associated with longer hospital stay, and significantly higher morbidity and mortality. Although the management of invasive candidiasis has greatly improved in these past years, the optimal management of intra-abdominal candidiasis remains elusive. Questions concerning the microbiological diagnosis, optimal antifungal drugs doses, diffusion through peritoneal fluid, and the value of liposomal amphotericin B as first-line treatment, remain unanswered. In this article, three important issues concerning intraabdominal candidiasis have been re-viewed: microbiological diagnosis and risk of antifungal resistance emergence, pharmacokinetic/pharmacodynamic particularities of antifungals, and clinical management on the daily practice. Only an optimized multidisciplinary approach combining rapid diagnostics, tailored antifungal therapy, and effective source control will improve the management and prognosis of patients with intra-abdominal candidiasis.