Table 2.

Reasons for changing first-line antifungal treatment

Days since initiation of therapy	Clinical and diagnostic findings compared with baseline
At any time	Identification of a pathogen resistant to primary antifungal therapy
8 to 14	On the basis of changes in GM:
	(i) Serum: The serum GM index has not fallen by either 1 unit or to <0.5 units based on measurements taken at least 7 days apart
	(ii) BAL: Positive GM from BAL in a patient with a previous BAL test that did not meet the definition of positive (too low or entirely negative) without regard for the interval of time between samples. Note that there is not a definition for rising GM index values from BAL as these values are subject to sampling error
	Or
	Clinical deterioration consistent with persisting or progressive invasive fungal disease with no other identifiable aetiology
	Or
	New distinct site of infection detected clinically or radiologically
≥15	Any of the above criteria
	Or
	Progression of original lesions on CT (or other imaging) based on >25% growth of initial lesions in the context of no change in immune status

GM, galactomannan.

Please note that equal weighting applies to each factor.