This is the protocol for a review and there is no abstract. The objectives are as follows:
The objectives of this review will be to determine the benefits and harms of the prophylactic administration of antifungal agents in nonneutropenic critically-ill patients.
The following primary questions will be examined where sufficient data are available:
Is prophylaxis with any antifungal agent(s) associated with reduced proven invasive fungal infections and total mortality compared with no prophylaxis?
Are some agent(s) alone or in combination more efficacious than others?
For each agent, does the efficacy depend upon dose, route of administration, and duration of prophylaxis?
Do some patient subgroups (e.g. medical versus surgical) derive greater benefit from antifungal prophylaxis than others?
Secondary questions will be examined where sufficient data are available:
Is antifungal prophylaxis associated with reduced suspected invasive fungal infections?
Is antifungal prophylaxis associated with reduced superficial fungal infections?
Is antifungal prophylaxis associated with reduced fungal colonization?
Is antifungal prophylaxis associated with increased colonization or infection with azole-resistant fungal strains or species?
Is prophylaxis with antifungal agent(s) associated with clinically-significant toxicity?
Is antifungal prophylaxis a cost-effective strategy?
If there is insufficient data of adequate quality to address these questions, the lack of good evidence will be highlighted.