Rational use of antifungals for invasive fungal infections in the institutional setting
The incidence of invasive fungal infections (IFIs) is increasing at an alarming rate. In the past decade alone, Candida spp. have become the fourth leading cause of nosocomial bloodstream infections in the United States (1). The incidence of Aspergillus infections is also increasing (2, 3). Much of this increase is thought to be a consequence of the growing numbers of patients at risk. With the expanded use of bone marrow and solid organ transplantation as life-saving therapies for malignancies and end-stage organ failure, the medical community is faced with a growing number of immunosuppressed patients. Furthermore, advances in the care of these patients are now sustaining them through the initial treatment phase, when bacterial infections were previously fatal, and into the time frame for increased risk from fungal pathogens.
