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Title: Antifungal stewardship: developments in the field.
Austin Authors: Urbancic, Karen F ;Thursky, Karin;Kong, David C M;Johnson, Paul D R ;Slavin, Monica A
Affiliation: Department of Infectious Diseases, Austin Health, Heidelberg, Victoria, Australia
Infectious Diseases Unit, Peter MacCallum Cancer Centre
Victorian Infectious Diseases Service, The Peter Doherty Institute for Immunity and Infection, Royal Melbourne Hospital, Parkville
National Centre for Antimicrobial Stewardship
Pharmacy Department, Ballarat Health Services, Ballarat
Centre for Medicine Use and Safety, Monash University, Parkville
National Centre for Infections in Cancer, Peter MacCallum Cancer Centre
Department of Medicine, University of Melbourne, Parkville
Pharmacy Department, Austin Health, Heidelberg, Victoria, Australia
Issue Date: Dec-2018
Publication information: Current opinion in infectious diseases 2018; 31(6): 490-498
Abstract: To outline key drivers and components of antifungal stewardship (AFS) programmes, the evidence for specific interventions, and methods to assess performance of programmes. Recent developments in antifungal resistance and breakthrough invasive fungal diseases have increased the urgency for effective AFS. In practice, however, few hospitals have dedicated AFS programmes. To date, AFS programmes have centred around the provision of expert bedside reviews and have reduced costs and consumption of antifungal agents. Incorporating tools such as fungal diagnostics and therapeutic drug monitoring into AFS programme models is recommended. However, the application and impact of these tools in this context have not been adequately assessed. The effectiveness of AFS programmes has been measured in multiple ways but a standardized method of evaluation remains elusive. Few studies have explored the impact of AFS interventions on patient outcomes. The uptake of formal AFS programmes has been slow. New initiatives integrating AFS tools in programmes, and measuring the impacts on patient outcomes are required given such data are not readily available. A comprehensive approach to evaluate AFS programmes by correlating the quantity and quality of antifungal prescribing with impacts on patient outcomes is needed. Consensus definitions for core AFS metrics are required to benchmark performance and are essential to the resourcing and sustainability of these programmes.
DOI: 10.1097/QCO.0000000000000497
ORCID: 0000-0002-9275-578X
PubMed URL: 30299362
Type: Journal Article
Appears in Collections:Journal articles

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