Antifungal agents for preventing fungal infections in non-neutropenic critically ill patients

Abstract

Analysis 1.4. Comparison 1 Primary analysis: untargeted antifungal treatment with any antifungal drug (systemic or nonabsorbable) compared to placebo/no antifungal/any other antifungal drug, Outcome 4 Suspected invasive fungal

Lessons from uncertainty on antifungal treatment in ICU

“…Authors described nicely the trial and some background evidence on untargeted antifungal treatment in non-neutropenic critically ill patients in ICU (2,3). However, we believe that some points may be further clarified.…”

Dying with or Because of Invasive Fungal Infection? The Role of Immunity Exhaustion on Patient Outcome

“…This has led to development of clinical scores, identification of fungal biomarkers and untargeted approaches for invasive fungal infection prevention (7,8). Evidence from randomized trials did not demonstrate, to date, an advantage of untargeted administration of antifungals in non-neutropenic critically ill patients (9,10). In this sense, antifungal drug administration has been included among the growing list of "the less is better" interventions in ICU.…”

Appropriate Treatment of Invasive Candidiasis in ICU: Timing, Colonization Index, Candida Score & Biomarkers, Towards de-Escalation?

“…However, since the effect of these common antifungal strategies in non-neutropenic critically ill patients on mortality was criticized (34,35), it may be reasonable to use these strategies acknowledging that, from an antifungal stewardship approach, de-escalation is the key!…”