Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Infect Dis. Nov 25, 2015; 5(4): 55-58
Published online Nov 25, 2015. doi: 10.5495/wjcid.v5.i4.55
How could we reduce antifungal use in the intensive care unit?
Anahita Rouzé, Karim Jaffal, Saad Nseir
Anahita Rouzé, Karim Jaffal, Saad Nseir, Critical Care Center, R. Salengro Hospital, University Hospital of Lille, 59037 Lille cedex, France
Anahita Rouzé, Saad Nseir, Medical School, Lille University, 59000 Lille, France
Author contributions: Rouzé A, Jaffal K and Nseir S drafted the manuscript; all authors read and approved the final version of the manuscript.
Conflict-of-interest statement: The authors declare no conflicts of interest regarding this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Saad Nseir, Professor, Critical Care Center, R. Salengro Hospital, University Hospital of Lille, boulevard du Pr Leclercq, 59037 Lille cedex, France. s-nseir@chru-lille.fr
Telephone: +33-3-20444084 Fax: +33-3-20445094
Received: June 4, 2015
Peer-review started: June 8, 2015
First decision: August 10, 2015
Revised: September 12, 2015
Accepted: October 12, 2015
Article in press: October 13, 2015
Published online: November 25, 2015
Core Tip

Core tip: Prompt appropriate antifungal treatment is associated with better outcome in patients with confirmed infections, this treatment has several drawbacks. Reducing antifungal treatment in the intensive care unit (ICU) is feasible, and would allow avoiding drawbacks of this treatment without negative impact on outcome. Antifungal stewardship, preemptive antifungal treatment, based on colonization index and fungal biomarkers; and de-escalation of antifungal treatment based on microbiology results and fungal biomarkers could be suggested to reduce antifungal use in the ICU, and are currently under investigation.