ABSTRACT

With improved laboratory techniques and the availability of new antifungal agents, complexity in the treatment of invasive fungal disease has rapidly increased over the past decade, stimulating a debate on the best management strategies.  In this chapter, we address four important areas of current uncertainty, including: 1) the role of therapeutic drug monitoring for voriconazole and posaconazole, 2) the utility of in vitro antifungal susceptibility testing of yeasts and moulds, 3) the optimal treatment of zygomycosis, and 4) the value of combination therapy for invasive aspergillosis.  For each topic, we examine the available evidence surrounding the ambiguity and then offer data-driven recommendations on how to proceed with management.