Can We Have Guidelines or Just Guidance for Rare Fungal Infections?

Area of Science:

• Infectious Diseases
• Medical Mycology
• Clinical Practice Guidelines

Background:

• Management of uncommon invasive fungal infections (IFIs) presents challenges.
• Limited and low-quality evidence complicates the establishment of diagnostic and treatment "gold standards" for rare IFIs.

Purpose of the Study:

• To discuss the limitations of current medical guidelines for rare IFIs.
• To propose that "guidance" may be a more suitable term than "guidelines" for managing rare IFIs.
• To raise questions about developing future recommendations for rare IFIs.

Main Methods:

• Perspective piece discussing existing literature and clinical challenges.
• Analysis of the evidence base for IFIs management.
• Conceptual discussion on terminology and guideline development.

Main Results:

• Current guidelines for rare IFIs are often based on scarce data, potentially leading to suboptimal or harmful patient management.
• Guidelines can be perceived as rigid, hindering individualized patient care for rare IFIs.
• Guidelines may not be updated frequently, failing to reflect the current treatment landscape.

Conclusions:

• The term "guidance" is proposed as more appropriate than "guidelines" for rare IFIs.
• Rethinking the construction of future recommendations for rare IFIs is necessary.
• Emphasis on critical examination and nuanced management of individual patients with rare IFIs is crucial.