To the Editor: The prospective study by Rex and colleagues (Nov. 17 issue)1 comparing amphotericin B with fluconazole for the treatment of candidemia concludes that the two treatments are equally effective. This opinion is echoed and endorsed in the accompanying editorial.2 Unfortunately, this randomized, controlled study may in some respects provide the right answer to the wrong question. It may be misconstrued as a mandate for the treatment of all patients with candidemia. Overall, patients with candidemia treated with either amphotericin B or fluconazole do not appear to have fared much better than untreated historical controls.3 I contend that no.
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