Early de-escalation of antifungal treatment in critically ill immunocompromised patients with proven or probable invasive candidiasis: A retrospective multicentre study
Authors' conclusion
Early AFT de-escalation occurred in 38% of critically ill immunocompromised patients, and was not associated with adverse prognostic outcomes.
Study context
- Population
- Critically ill immunocompromised patients in ICU ≥5 days treated with antifungals for a first proven or probable invasive candidiasis episode, 19 ICUs in France, 2019–2024analysed
- Participants
- 242 participants
- Exposure
- Early antifungal treatment de-escalation vs no de-escalation
- De-escalationn = 92
- Outcome
- Incidence of early antifungal treatment de-escalation (censored at day 28 after initiation)
Methodological detailsmulticentre
- Multicentre
Main finding
As reported in the abstract
Early antifungal treatment de-escalation
Early de-escalation, n
92
Early de-escalation, %
38%
95% CI 31.9%–44.2%
Observational data: associations, not effects.
Further findings
Type of de-escalation
- Spectrum reduction
- 35.9%
- Discontinuation
- 64.1%
ICU mortality, ICU LOS, ventilator-free days
- No difference between patients with and without de-escalation
Safety
- Antifungal treatment re-initiated within 7 days of de-escalation
- 6.5% · 6 of 92
Original publication
Early de-escalation of antifungal treatment in critically ill immunocompromised patients with proven or probable invasive candidiasis: A retrospective multicentre study. Ann Intensive Care. Published 25 August 2026. doi:10.
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