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EQUAL Score Scedosporiosis/Lomentosporiosis 2021: a European Confederation of Medical Mycology (ECMM) tool to quantify guideline adherence.

Authors :
Stemler, Jannik
Lackner, Michaela
Chen, Sharon C -A
Hoenigl, Martin
Cornely, Oliver A
Source :
Journal of Antimicrobial Chemotherapy (JAC); Jan2022, Vol. 77 Issue 1, p253-258, 6p
Publication Year :
2022

Abstract

<bold>Background: </bold>Invasive scedosporiosis and lomentosporiosis are life-threatening fungal infections in immunocompromised patients with complex diagnostic and treatment patterns.<bold>Objectives: </bold>To develop a scoring tool to facilitate and quantify adherence to current guideline recommendations for diagnosis, treatment and follow-up of invasive scedosporiosis and lomentosporiosis.<bold>Methods: </bold>Experts from European Confederation of Medical Mycology (ECMM) excellence centres reviewed current guidelines for scedosporiosis and lomentosporiosis. Recommendations for diagnosis, treatment and follow-up were summarized, assembled and weighted according to their strength of recommendation and level of evidence (strongly recommended = 3 points; moderately recommended = 2 points; marginally recommended = 1 point; recommended against = 0 points). Additional items considered of high importance for clinical management were also weighted.<bold>Results: </bold>A total of 170 recommendations were identified. A 21-item tool was developed and embedded into the EQUAL score card. Nine items for diagnosis with 18 achievable points were assembled. For treatment, three general recommendation items with a maximal score of 9 were identified, while for specific antifungal treatment the two fungal pathogens were separated. Three and four items were established for scedosporiosis and lomentosporiosis, respectively, with a maximum achievable score of 3 due to the separation of different treatment options with the maximum point value of 3 for voriconazole-based treatment. Follow-up comprised two items (4 points maximum). Key recommendations for clinical outcome were weighted accordingly.<bold>Conclusions: </bold>We propose the EQUAL Score Scedosporiosis/Lomentosporiosis to quantify adherence to current guideline recommendations for management of these rare infections. The score remains to be validated in real-life patient cohorts and correlated with patient outcome. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
03057453
Volume :
77
Issue :
1
Database :
Complementary Index
Journal :
Journal of Antimicrobial Chemotherapy (JAC)
Publication Type :
Academic Journal
Accession number :
154595937
Full Text :
https://doi.org/10.1093/jac/dkab355