The global burden of invasive fungal diseases (IFDs) continues to increase, particularly among critically ill patients, where mortality remains high —reaching up to 70 %— despite major advances in antifungal therapy, including the introduction of novel agents such as isavuconazole, improved lipid formulations of amphotericin B, and the broader use of mold-active azoles and echinocandins [1]. In this context, the recent American Thoracic Society (ATS) clinical practice guidelines address two key and still debated issues in IFD management: the use of combination antifungal therapy (CAF) for invasive pulmonary aspergillosis (IPA), and the role of antifungal prophylaxis and empirical treatment for invasive candidiasis (IC) in the intensive care unit (ICU) setting [2].
