Universität zu Köln

Sprute, Rosanne ORCID: 0000-0003-2457-6437, Van Braeckel, Eva, Flick, Holger, Hoenigl, Martin ORCID: 0000-0002-1653-2824, Kosmidis, Chris ORCID: 0000-0003-0662-1265, Agarwal, Ritesh ORCID: 0000-0003-2547-7668, Davidsen, Jesper R., Laursen, Christian B. ORCID: 0000-0001-6382-9906, Cornely, Oliver A. ORCID: 0000-0001-9599-3137 and Seidel, Danila (2023). EQUAL CPA Score 2022: a tool to measure guideline adherence for chronic pulmonary aspergillosis. J. Antimicrob. Chemother., 78 (1). S. 225 - 232. OXFORD: OXFORD UNIV PRESS. ISSN 1460-2091

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Abstract

Background Chronic pulmonary aspergillosis (CPA) can complicate underlying pulmonary diseases, and clinical management of CPA is challenging. Guidelines support clinicians but due to the complexity of the disease they can be difficult to adhere to. Objectives To map current guideline recommendations for the clinical management of CPA into a scoring tool to facilitate and quantify guideline adherence in clinical practice. Methods Recommendations for diagnosis, treatment and follow-up of CPA presented in the current ESCMID/ERS/ECMM and CPAnet guidance documents were assembled and weighed on the basis of their strength of recommendation and level of evidence. Results Twenty-seven recommendations were identified, resulting in a total maximum EQUAL CPA Score of 51. For diagnostics (Score(Max )= 27), a strong emphasis on expert consultation, culture, direct microscopy, histopathology, serology and imaging was reflected in respective points, whereas molecular techniques and susceptibility testing count into the diagnostics score to a lesser extent. Ten treatment recommendations (Score(Max )= 14), including antifungal therapy, therapeutic drug monitoring and treatment duration, were identified. Surgery, where indicated, adds three points. For refractory disease or intolerance of first-line antifungal treatment, optimal second-line treatment added another two points. During follow-up (Score(Max )= 10), response assessment via imaging gave three points, while culture and serology added two points each to the Score(Max). Conclusion The EQUAL CPA Score intents to be used as a comprehensive tool for measuring guideline adherence. If adherence to current guidelines is associated with clinical outcome, this will be assessed in future studies.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Sprute, Rosanne UNSPECIFIED orcid.org/0000-0003-2457-6437 UNSPECIFIED Van Braeckel, Eva UNSPECIFIED UNSPECIFIED UNSPECIFIED Flick, Holger UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoenigl, Martin UNSPECIFIED orcid.org/0000-0002-1653-2824 UNSPECIFIED Kosmidis, Chris UNSPECIFIED orcid.org/0000-0003-0662-1265 UNSPECIFIED Agarwal, Ritesh UNSPECIFIED orcid.org/0000-0003-2547-7668 UNSPECIFIED Davidsen, Jesper R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Laursen, Christian B. UNSPECIFIED orcid.org/0000-0001-6382-9906 UNSPECIFIED Cornely, Oliver A. UNSPECIFIED orcid.org/0000-0001-9599-3137 UNSPECIFIED Seidel, Danila UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-691262
DOI:	10.1093/jac/dkac378
Journal or Publication Title:	J. Antimicrob. Chemother.
Volume:	78
Number:	1
Page Range:	S. 225 - 232
Date:	2023
Publisher:	OXFORD UNIV PRESS
Place of Publication:	OXFORD
ISSN:	1460-2091
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language RANDOMIZED CONTROLLED-TRIAL; CHRONIC CAVITARY; ITRACONAZOLE; VORICONAZOLE; EFFICACY Multiple languages Infectious Diseases; Microbiology; Pharmacology & Pharmacy Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/69126