Antimicrobial viewpoint: From fixed courses to flexible care - reconsidering antifungal treatment duration and route

Invasive fungal infections are life-threatening conditions that predominantly affect immunocompromised or critically ill patients, carrying high mortality and morbidity across any fungal species and disease manifestation. Given the scarcity of well-designed clinical trials and complex patient management, antifungal treatment decisions are often tradition-driven rather than evidence-based, resulting in prolonged treatment durations and reluctance to switch to oral regimens. In bacterial infections, a growing body of evidence of large, randomised trials supports shorter antibiotic courses and oral routes, even in severe diseases such as sepsis and bloodstream infections (1–4).