title: Does the current treatment of invasive fungal infection need to be reviewed?
abstract: Invasive fungal infections (IFIs) are becoming more frequent due to the increasing number of patients at risk. Over the last decade, their prognosis has improved with the diagnostic and therapeutic advances, including new antifungals. In the two years, from 2007 to 2009, antifungal consumption increased by 27%, 67 times more than antibacterial consumption, albeit with great differences between hospitals. The scientific evidence of the indications for antifungal prophylaxis and targeted antifungal therapy is strong; however, it is weak for empirical antifungal therapy, which is the most common indication. Antifungals are not harmless, since they are associated with a wide range of adverse effects and drug interactions, favor the development of resistance, contribute to other fungal superinfections and cause significant healthcare spending. Therefore, the question arises whether this extraordinary increase in consumption is justified, whether the use of antifungals is optimal, or whether it is necessary to reconsider the current treatment of IFIs instead.
authors.affiliation: Department of Infectious Diseases, Microbiology and Preventive Medicine, Institute of Biomedicine of Seville (IBiS), Virgen del Rocío University Hospital/CSIC/University of Seville, Seville, Spain; Spanish Network for Research in Infectious Diseases (REIPI), Spain.
authors.forename: Almudena
authors.initials: A
authors.lastname: Martín-Peña
authors.affiliation: Department of Infectious Diseases, Microbiology and Preventive Medicine, Institute of Biomedicine of Seville (IBiS), Virgen del Rocío University Hospital/CSIC/University of Seville, Seville, Spain; Spanish Network for Research in Infectious Diseases (REIPI), Spain.
authors.forename: Manuela
authors.initials: M
authors.lastname: Aguilar-Guisado
authors.affiliation: Department of Infectious Diseases, Microbiology and Preventive Medicine, Institute of Biomedicine of Seville (IBiS), Virgen del Rocío University Hospital/CSIC/University of Seville, Seville, Spain; Spanish Network for Research in Infectious Diseases (REIPI), Spain. Electronic address: josem.cisneros.sspa@juntadeandalucia.es.
authors.forename: José Miguel
authors.initials: JM
authors.lastname: Cisneros
mesh_terms: D000935:Antifungal Agents / Q000009:adverse effects / Q000627:therapeutic use*; D058365:Candidiasis, Invasive / Q000188:drug therapy; D002986:Clinical Trials as Topic; D016638:Critical Illness; D019468:Disease Management; D025141:Drug Resistance, Fungal; D004363:Drug Utilization / Q000639:trends; D006402:Hematologic Diseases / Q000150:complications; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D055744:Invasive Pulmonary Aspergillosis / Q000188:drug therapy; D009181:Mycoses / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology; D009369:Neoplasms / Q000150:complications; D009503:Neutropenia / Q000150:complications; D012307:Risk Factors
chemical_list: D000935:Antifungal Agents
keywords: Antifungal consumption; Antifungal therapy; Consumo de antifúngicos; Infección fúngica invasora; Invasive fungal infection; Terapia antifúngica