Invasive Candidiasis in the ICU: Diagnosis, Echinocandins, Resistance

This narrative review consolidates current epidemiology, diagnostics, and antifungal management of invasive candidiasis for ICU pharmacists confronting rising non-albicans resistance and delayed diagnosis.

📅 Journal publication: Jun 2026 (online Dec 30, 2025) · Last updated: Jul 13, 2026

echinocandinsmicafungincaspofunginanidulafunginrezafunginfluconazoleamphotericin-BCandida aurisinvasive candidiasiscandidemiaintra-abdominal candidiasisantifungal stewardship13-beta-D-glucanT2 Candidacritical carenarrative review Critical Care / ICU

Background Information

Invasive candidiasis is a deadly ICU complication needing swift action.

Invasive candidiasis is a serious infection in ICU patients with high mortality and can be difficult to diagnose early. Non-albicans Candida species are increasingly common, and newer molecular tests provide faster diagnosis but remain costly. First-line treatment with echinocandin antifungals is effective, but timely diagnostics are crucial; newer drugs are in development for resistant cases. Early diagnosis and treatment of invasive candidiasis are vital in ICU settings.

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Authors: Pérez MA, Hoffmann WJ, Pérez JC, Adelman MW

Citation: Pérez MA, Hoffmann WJ, Pérez JC, et al. Invasive Candidiasis in Critically Ill Patients: Fundamental Concepts and Future Directions. Chest. 2026;169(6):1561-1574. doi:10.1016/j.chest.2025.12.020

Article Links: PubMed · Journal / DOI · Free Full Text (PMC)

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Executive Summary

Study Design

Patient Population

Primary Outcomes

Secondary Outcomes & Safety Profile

Pharmacist Implications

Clinical Pearls

Limitations

Controversies & Evidence Gaps

Cost & Logistics

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