Febrile neutropenia: antifungal prophylaxis

Despite being widely practised there is little or no evidence to support the use of antifungal prophylaxis in febrile neutropenic patients. With the greater recognition of risk factor, the increasing readiness to use imaging techniques such as the high resolution CT scan and new methods for detecting fungi such as Aspergillus galactomannan on the one hand and the widening choice of drugs on the other hand, it may be possible to move away from prophylaxis towards pre-emptive treatment when the prevalence of fungal disease is low. However, the case still has to be proven convincingly by conducting formal clinical trials. (C) 2000 Elsevier Science B.V. and International Society of Chemotherapy. All rights reserved.