[Empirical antifungal therapy in patients with febrile neutropenia]

The empiric use of antimicrobial agents in febrile neutropenia is a generally accepted practice. Antifungal empiric therapy is used in neutropenic patients with persistent or recurrent fever after 4 - 6 days of treatment onset with broad-spectrum antibiotics. This therapy aims at treating any non-diagnosed invasive fungal infections (IFIs), preventing the development of IFIs and eventually reducing the mortality associated with these infections. After a review of empiric antifungal therapy, this article poses the following question: Which is the best empiric antifungal therapy option for neutropenic patients? There is no doubt the answer to this question is not simple and, even more important, with a better understanding of the progression of patients with febrile neutropenia and IFI risk groups, the imperative question is: Should any patient with persistent fever receive empiric antifungal therapy?