Between Over- and Undertreatment of Invasive Fungal Disease

Pauw comments on Maertens et al's study on preemptive antifungal therapy in neutropenic patients at high risk for invasive fungal infection. Maertens et al rightly proposed that a randomized trial of preemptive therapy versus empirical therapy should be done to confirm their findings. However, it may be inadvisable to attempt such a trial, because the value of the conventional empirical strategy against Aspergillus species remains controversial and would fuel endless discussions about which antifungal drugs should be used.