Preventative use of antifungal drugs in patients treated for cancer

Prophylactic use of antifungal compounds has more or less become standard clinical practice for patients who are treated for a haematological malignancy. However, apart from the prevention of infections by Candida species in bone marrow transplant recipients and a possible reduction in invasive aspergillosis in high-risk patients, there is little evidence to justify this approach. Antifungals ought to be administered to patients on their perceived individual risk and better studies should be conducted to provide a more rational basis for our clinical decisions. Results of studies in specific populations should not be used to create guidelines for other patient groups or general populations. Antifungals are potentially toxic and overuse might be associated with unnecessary direct and indirect drug-related costs.