SEVERE INFECTIONS: Edited by Jean-François TimsitAdequate duration of therapy in severe fungal infectionsBassetti, Matteoa,b; Giacobbe, Daniele R.a; Berruti, Marcoa; Del Puente, Filippoa; Vena, AntonioaAuthor Information aInfectious Diseases Unit, Ospedale Policlinico San Martino – IRCCS bDepartment of Health Sciences (DISSAL), University of Genoa, Genoa, Italy Correspondence to Matteo Bassetti, Infectious Diseases Unit, Ospedale Policlinico San Martino – IRCCS, University of Genoa, L.go R. Benzi, 10, 16132 Genoa, Italy. Tel: +39 010 555 4658; fax: +39 010 5556712; e-mail: [email protected] Current Opinion in Critical Care: October 2020 - Volume 26 - Issue 5 - p 466-472 doi: 10.1097/MCC.0000000000000758 Buy Metrics Abstract Purpose of review To highlight recent findings on the adequate duration of antifungal therapy in patients with invasive fungal disease (IFD). Recent findings Plenty of published data available suggest that there is no additional clinical benefit at a certain point after initiation of antifungal treatment in patients with confirmed IFD. Moreover, the prolonged antifungal exposure can be associated with an increased risk of side effects and toxicity as well as striking risk for developing antifungal resistance or rising unnecessary healthcare costs. Recent data suggest that, in the presence of an adequate initial antifungal therapy and adequate source control of the infection, new stratified approaches integrating clinical judgment, biomarkers and microbiological eradication, should be considered as an alternative to the ‘one-size-fits-all’ treatment duration currently used worldwide. Summary The optimal duration of antifungal therapy is still an unresolved issue that depends by many key elements including the host; the pathogen and its microbiological eradication, the adequateness of initial antifungal therapy and the promptness of source control of the infection. In general, many patients with invasive candidiasis can be treated with a 2 weeks course of antifungal therapy. Longer antifungal course (6 weeks or more) is generally required for patients with invasive aspergilosis. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.