Management of Invasive Fungal Infection: Clinical Strategies in Critical Care from a Multidisciplinary Consensus.

Abstract

Fungal infections pose a growing threat in hospital settings, particularly among critically ill or immunocompromised patients. A multidisciplinary consensus among fifteen clinical experts from Northern Italy examined the increasing challenge of invasive fungal infections, especially in patients with high-risk complications and in critical settings. The report emphasizes early diagnostic integration through clinical assessment, biomarker evaluation, and the essential role of therapeutic drug monitoring in optimizing outcomes. This consensus aims to consolidate clinical strategies for timely diagnosis, personalized pharmacologic intervention, and antifungal stewardship. Azoles are identified as first-line treatment options. Isavuconazole emerged as a preferred therapeutic agent due to its favorable pharmacokinetic profile, safety in renal impairment, and lack of QT interval prolongation. This consensus supports integrated strategies combining early recognition, rapid diagnostics, individualized pharmacology, and antifungal stewardship to improve outcomes, particularly in critical care settings.