Appropriateness and cost-effectiveness in the treatment of invasive candidiasis in Internal Medicine Wards

Invasive candidiasis (IC), including candidemia, is a major cause of morbidity and mortality among patients and the majority of cases of candidemia are documented in Medical Wards. Early identification of patients at risk, knowledge of local epidemiology and prompt efforts to define etiologic diagnosis are pivotal to ensure appropriateness. Start with an echinocandin and switch to fluconazole when possible, seems to represent a useful strategy for the management of IC. The choice between the three echinocandins should be based on the specific indications, pharmacokinetic/pharmacodynamic profile, clinical experience and cost.