For Continued Sepsis, Empiric Antifungal Therapy Still Falls Short

A trend toward greater infection-free survival with micafungin than with placebo was not significant.

Infectious Diseases Society of America guidelines recommend considering empiric antifungal therapy in febrile, critically ill patients who are at risk for invasive candidiasis. However, previous placebo-controlled studies of severely ill patients with unresolved sepsis identified no significant advantage of fluconazole (NEJM JW Infect Dis Sep 2008 and Ann Intern Med 2008; 149:83) or caspofungin (NEJM JW Infect Dis Jun 2014 and Clin Infect Dis 2014; 58:1219). Now, in the partially manufacturer-funded EMPIRICUS trial from 19 intensive care units in France, patients with unresolved sepsis, multiorgan failure, and evidence of extra-intestinal Candida colonization were randomized to receive empiric intravenous micafungin (100 mg/day) or placebo …

Reviewing Author

Neil M. Ampel, MD

Disclosures

Editorial BoardsUpToDate

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

Neil M. Ampel, MD

Disclosures

Editorial BoardsUpToDate

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

For Continued Sepsis, Empiric Antifungal Therapy Still Falls Short

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Reviewing Author