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Related Concept Videos

Antifungal Agents01:15

Antifungal Agents

Amphotericin B is a broad-spectrum antifungal agent that exploits structural differences between fungal and mammalian cell membranes. Its amphipathic structure—featuring a hydrophobic polyene-lactone ring and a hydrophilic region containing mycosamine and carboxylic acid groups—enables selective binding to ergosterol, a sterol predominantly found in fungal plasma membranes. This selective interaction underlies the drug’s antifungal activity, although weak binding to cholesterol contributes to...
Antimicrobial Effectiveness01:28

Antimicrobial Effectiveness

The effectiveness of antimicrobial agents depends on various factors influencing their ability to eliminate microbial populations. Larger microbial populations require more time for complete eradication, emphasizing the importance of population size analysis when evaluating antimicrobial efficacy.Microbial resistance to antimicrobial agents varies significantly. Highly resilient microorganisms include endospores, gram-negative bacteria, and non-enveloped viruses, while prions are exceptionally...
Healthcare Associated Infections II: Preventive Measures01:22

Healthcare Associated Infections II: Preventive Measures

Essential infection prevention measures are based on the knowledge of the infection chain, the modes of transmission in healthcare settings, and the use of the best practices in all healthcare settings. Compulsory public reporting of healthcare-associated infection rates is needed to allow individuals and the community to make informed choices regarding selecting a healthcare facility.
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
Overview of Fungi01:29

Overview of Fungi

Fungi are a diverse group of eukaryotes more closely related to animals than other eukaryotes. Fungal cell walls comprise chitin, a polysaccharide that provides structural strength, and glucans, which contribute to flexibility and integrity. Other polysaccharides, such as mannans and galactosans, may supplement or replace chitin in some fungi. These adaptations, along with their preference for acidic environments and tolerance for high osmotic pressure, enable fungi to thrive in various...
Endocarditis III: Medical Management01:18

Endocarditis III: Medical Management

Infective endocarditis management involves a multifaceted approach encompassing infection prevention, lifestyle modifications, pharmacological therapy, and surgical management.Infection Prevention:Hand Hygiene: Thorough handwashing is crucial to prevent the spread of infection. Hand hygiene should be performed regularly, especially before and after using the restroom.Oral Hygiene: Good oral hygiene is essential. It includes brushing teeth immediately after waking up and before bed, flossing...
Fungal Phylum Microsporidia01:28

Fungal Phylum Microsporidia

Microsporidia are a group of obligate intracellular fungi that were initially classified as protists but were later reclassified based on phylogenetic, molecular, and structural evidence linking them to the Chytridiomycota. These unicellular, non-motile organisms are highly specialized parasites that infect a wide range of animal hosts, including humans. They have evolved extensive genomic and metabolic reductions, making them highly dependent on their hosts for survival.Morphology and Genomic...

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Whole Genome Sequencing of Candida glabrata for Detection of Markers of Antifungal Drug Resistance
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Published on: December 28, 2017

The case for antifungal stewardship.

Michelle R Ananda-Rajah1, Monica A Slavin, Karin T Thursky

  • 1Infectious Diseases Unit, Alfred Health, Infectious Diseases Department, Peter MacCallum Centre, Victorian Infectious Diseases Service, Royal Melbourne Hospital, Melbourne, Victoria, Australia. m.ananda-rajah@alfred.org.au

Current Opinion in Infectious Diseases
|November 30, 2011
PubMed
Summary

Antifungal stewardship (AFS) programs are crucial for managing invasive fungal diseases (IFDs) and optimizing antifungal drug use. Implementing AFS guidelines improves patient outcomes and reduces healthcare costs.

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Area of Science:

  • Infectious Diseases
  • Clinical Pharmacy
  • Antimicrobial Resistance

Background:

  • Antimicrobial stewardship (AMS) has historically prioritized antibiotics, neglecting antifungal agents despite documented prescribing deficiencies.
  • Invasive fungal diseases (IFDs), though less common than bacterial infections, impose significant health and economic burdens.
  • High drug costs and toxicity of antifungals necessitate dedicated antifungal stewardship (AFS).

Purpose of the Study:

  • To review the essential components of antifungal stewardship (AFS).
  • To highlight AFS elements distinct from traditional antibiotic stewardship (AMS).
  • To share practical insights and experiences in implementing AFS.

Main Methods:

  • Review of existing literature on antifungal drug use and stewardship.
  • Analysis of the challenges and opportunities in AFS implementation.
  • Discussion of the role of diagnostics and performance indicators in AFS.

Main Results:

  • Invasive fungal diseases (IFDs) contribute substantially to hospital costs, with antifungal agents being a major cost driver.
  • Overuse of antifungals is driven by IFD severity, impact on chemotherapy, and diagnostic limitations.
  • De-escalation of empiric antifungal therapy presents a significant implementation challenge.
  • Nonculture-based tests show promise for enhancing AFS but require refined application.

Conclusions:

  • Context-specific practice guidelines are fundamental to effective AFS.
  • Local epidemiology is essential for selecting appropriate antifungal agents for IFD prevention and treatment.
  • Adherence to prescribing standards optimizes clinical outcomes and minimizes drug toxicity, aligning with healthcare quality goals.