D-Index–Guided Early Antifungal Therapy Versus Empiric Antifungal Therapy for Persistent Febrile Neutropenia: A Randomized Controlled Noninferiority Trial

RCT (n=413) concludes incidence of probable/proven invasive fungal infection was lower in the D-Index–Guided Antifungal Therapy (DET) group vs the empiric antifungal therapy group (0.5% vs 2.5%), which fulfilled the predetermined criterion of noninferiority of the DET group.

SPS commentary:

D-index–guided early antifungal therapy involves use of antifungal treatment only when a D-index reaches 5,500 or at detection of positive serum or imaging tests.

Journal of Clinical Oncology