Should Early Empirical Mold-Active Antifungals Be Given for Severe Influenza Pneumonia?

Clinical Takeaway

: In an observational study, early therapy lowered the 30-day incidence of influenza-associated pulmonary aspergillosis but did not alter the 30-day mortality rate.

Context

Influenza-associated pulmonary aspergillosis (IAPA) syndrome occurs in up to 20% of patients admitted to the intensive care unit (ICU) and is associated with 50% mortality. To ascertain if early empirical antifungal therapy is helpful, researchers studied all patients admitted to one of nine Austrian ICUs with influenza-associated acute respiratory failure between 2016 and 2025. Of the 172 patients, 61 received mold-active antifungal therapy within 24 hours of ICU admission. Posaconazole was the antifungal used in 57 instances.

Key Results

A total of 24 patients (14%) developed IAPA, including 11 within 24 hours of ICU admission. Patients who received early empirical antifungal therapy had a significantly lower 30-day incidence of IAPA…

Reviewing Author

Neil M. Ampel, MD

Disclosures

Editorial BoardsUpToDate

Leadership Positions in Professional SocietiesCoccidioidomycosis Study Group (Past President, Secretary, Treasurer)