Preemptive antifungal therapy: still a way to go

Purpose of Review Early treatment of invasive mold infections improves the outcome. Therapy is often delayed, however, because available diagnostic tools such as culture, microscopy and conventional radiology lack sensitivity; consequently, empirical initiation of antifungal therapy has been advocated, particularly for patients with prolonged unexplained neutropenic fever. Recent findings Much recent progress has been made in the development and evaluation of nonculture-based assays, including the detection of the fungal antigens galactomannan and beta-D-glucan and the detection of fungal DNA by polymerase chain reaction techniques. These new tools should aid the rapid, early diagnosis if invasive disease, especially when used as screening tools in conjunction with sensitive imaging techniques. Summary The review will consider thee recent developments with the purpose of introducing the concept of preemptive antifungal therapy.