Empiric anti-Candida therapy for patients with sepsis in the ICU: how little is too little?

Prior analyses suggest that empiric fluconazole for ICU patients with sepsis is cost-effective. Using updated estimates of efficacy and cost, Zilberberg et al compare the use of micafungin with that of fluconazole.

The authors conclude that micafungin is an attractive alternative to fluconazole. This conclusion is driven by recent reduction in micafungin's cost and by better activity of micafungin against azole-resistant Candida species.

Their results are limited by inflated estimates of efficacy, life expectancy and risk of Candida sepsis. This commentary explores the rational for early anti-Candida strategies in the ICU and highlights the contribution and limitations of the article by Zilberberg et al.

Author: Yoav Golan
Credits/Source: Critical Care 2009, 13:180

Published on: 2009-08-21

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