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Invasive candidiasis increases morbidity and mortality in patients who have prolonged ICU stays. Some small studies have shown that prophylactic use of antifungal agents can reduce the incidence of such infections and the attendant morbidity and mortality. However, this strategy treats many patients who may not be at risk for invasive candidiasis and increases the chances that drug-resistant Candida strains will emerge. But what about empirical use of such agents?
In a double-blind, multisite, manufacturer-supported study conducted between 1995 and 2000, researchers evaluated treatment success (defined as a composite of fever resolution, absence of invasive fungal infection, lack of toxicity-related treatment discontinuation, and lack of nee…