Antifungal Therapy in Patients with Fever and Neutropenia — More Rational and Less Empirical?

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Abstract
Empirical antibacterial therapy for fever and neutropenia has dramatically improved outcomes in a large number of patients, making it possible for many to undergo successful antineoplastic therapy. Because the diagnosis of fungal infection in patients with neutropenia can be difficult and because delays in instituting effective antifungal therapy are associated with increased mortality, the concept of empirical antifungal therapy with amphotericin B has emerged. Empirical antifungal therapy has become accepted clinical practice, and there are now alternatives to conventional amphotericin B — namely, liposomal amphotericin B and voriconazole.1 In this issue of the Journal, Walsh et al.2 report the results . . .