Editorial Response: Should All Patients with Candidemia Be Treated with

In this issue of CID. Fraser et al. have presented a careful, in-depth analysis of the risk factors, therapy, and outcome for patients with candidemia at a large urban medical center during a l-year period between 1988 and 1989. In their dis-cussion they state, "The significant mortality associated with most episodes of candidemia underscores the need to diag-nose and treat all candidemic patients quickly. The total dose and duration of antifungal therapy should be deter-mined several days into therapy, after the patient's candide-mia has been identified as either transient or sustained. " This statement suggests an approach to candidemia that is nearly opposite to the conventional, less-aggressive therapeutic ap-proach ofprevious years. In light ofthe developing epidemio-logical data on candidemia, the recommendation ofFraser et al. is highly meritorious