Ostrosky-Zeichner L.
Curr Opin Infect Dis 2009;22:564–7.
The purpose of this review is to discuss clinical trials of antifungal agents in the critical care setting and the methodological issues surrounding them. Critically ill patients have traditionally been under-represented in clinical trials of antifungals; however, interest in the use of antifungal agents as prophylaxis, pre-emptive, and empirical therapy has increased. Although data are limited, the use of antifungals for these purposes among highly select populations of the critically ill may be warranted.
Although invasive fungal infections are a major cause of morbidity and mortality among critically ill patients, this population is often under-represented in clinical trials of antifungals. Therefore, the safety and efficacy of antifungals in this setting is often extrapolated from less severely ill patient populations.