The role of inhaled antifungals for prophylaxis and treatment of invasive fungal pneumonias remains undefined. Herein we summarize recent clinically relevant literature in high-risk groups such as neutropenic hematology patients, including those undergoing stem cell transplant, lung and other solid transplant recipients, and those with sequential mold lung infections secondary to viral pneumonias. Although there are several limitations of the available data, inhaled liposomal amphotericin B administered 12.5 mg twice weekly could be an alternative method of prophylaxis in neutropenic populations at high risk for invasive fungal pneumonia where systemic triazoles are not tolerated. In addition, inhaled amphotericin B has been commonly used as prophylaxis, pre-emptive, or targeted therapy for lung transplant recipients but is considered as a secondary alternative for other solid organ transplant recipients. Inhaled amphotericin B seems promising as prophylaxis in fungal pneumonias secondary to viral pneumonias, influenza, and SARS CoV-2. Data remain limited for inhaled amphotericin for adjunct treatment, but the utility is feasible.

Objective: The aim of this study is to determine the predictive values of MRSA swab screenings in patients with cancer. Methods: This is a retrospective cohort observational study of adult patients admitted to The University of Texas MD Anderson Cancer Center between January 2019 and October 2022. Data collected from patients with documented MRSA nasal swab screenings and clinical cultures taken within 7 days were collected. The first documented MRSA swab screening and culture results from unique patients were included for analysis to calculate sensitivity, specificity, positive predictive value, and NPV. Results: A total of 6475 patients with MRSA nasal swab cultures had 13129 clinical cultures from different anatomical sites. Of the patients included, 57% had a solid tumor and 37% had a hematological malignancy, with 82% of patients receiving an anti-MRSA antibiotic prior to MRSA nasal swab. There were 167 documented positive MRSA cultures, most commonly from a wound (41.3%) or respiratory source (24%). Overall sensitivity and specificity for all culture sites were 50.9% and 98.4%, respectively, with an overall NPV of 99.4%. The NPV was 99.8% for bloodstream infections, 98.5% for respiratory infections, 92.6% for wound infections, and greater than 99% for other culture sites. Conclusion: The specificity and negative predictive value of MRSA swab screenings in patients with cancer was high overall and consistent with the literature in immunocompetent patients. These results may aid in antimicrobial stewardship activities that can help guide the discontinuation of empiric antibiotics in patients with cancer.

In this perspective, we discuss the limitations of medical guidelines as it relates to the management of uncommon invasive fungal infections (IFIs) or infrequent manifestations of more common IFIs. We emphasize the difficulties to define “gold standards” for diagnostics and treatment based on limited and low-quality evidence. We posit that such “guidelines” based on scarce data may be suboptimal and could be in some cases even harmful. Specifically, guidelines are often seen as rigid rules to follow which can prevent a critical examination of the nuanced management of individual patients with rare IFIs. We also emphasize that guidelines are often not updated frequently enough and therefore may not reflect the current treatment landscape. For all those reasons, we suggest that the term “guidance” may be more appropriate than “guidelines” for rare IFIs. Finally, we pose several questions regarding constructing future “Guidelines”/“Guidance for such entities”.

This review provides summarization of the most significant infectious diseases (ID) pharmacotherapy articles published in peer-reviewed literature in 2025. Members of the Houston Infectious Diseases Network (HIDN) nominated notable articles providing significant contributions to ID pharmacotherapy in 2025. Article nominations included those pertaining to general ID and human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) pharmacotherapy. To aid selection of the most notable articles of 2025, a survey was created and distributed to members of the Society of Infectious Diseases Pharmacists (SIDP). A total of 32 articles were nominated by HIDN/SIDP members, 26 articles related to general ID pharmacotherapy and 6 articles focusing on HIV/AIDS. Of the 212 SIDP members who participated in the survey, there were 101 recorded votes for the top 10 general ID pharmacotherapy articles and 40 votes recorded for the top HIV/AIDS article. The most notable publications are summarized. Ongoing research continues to discover findings that enhance antimicrobial stewardship and inform best practices in infectious diseases. From over 2000 articles published on PubMed using the keywords “infectious diseases,” “HIV,” “pharmacotherapy,” and “anti-infective,” this review highlights and summarizes the most influential ID publications with aims to update clinicians on potentially practice-changing ID pharmacotherapy publications from 2025.