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Updated: Dec 28, 2025

Whole Genome Sequencing of Candida glabrata for Detection of Markers of Antifungal Drug Resistance
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Do we need to adopt antifungal stewardship programmes?

Konstantinos Ioannidis1, Apostolos Papachristos1, Ioannis Skarlatinis1

  • 1Department of Clinical Pharmacy, Diagnostiko kai Therapeftiko Kedro Athinas - Hygeia, Athens, Greece.

European Journal of Hospital Pharmacy : Science and Practice
|February 18, 2020
PubMed
Summary
This summary is machine-generated.

Implementing antifungal stewardship is crucial for optimizing treatment and reducing costs. This study found that only 23 of 51 eligible patients had their antifungal therapy de-escalated, leading to significant unnecessary expenses and potential resistance.

Keywords:
candidemiade-escalationechinocandinsfinancial lossstewardship programs

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Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Antimicrobial Stewardship

Background:

  • Antimicrobial stewardship programs are a healthcare priority, yet antifungal stewardship implementation and focus areas are under-discussed.
  • Limited research exists on optimizing antifungal therapy and preventing resistance.

Purpose of the Study:

  • To evaluate the rate of antifungal therapy de-escalation in patients with candidaemia.
  • To determine the economic impact of step-down or step-up antifungal therapy.
  • To assess potential increases in minimum inhibitory concentrations or the emergence of resistant Candida species.

Main Methods:

  • Retrospective analysis of patients receiving systemic antifungal therapy for candidaemia between 2011 and 2016.
  • Statistical analysis and diagrams were used to assess de-escalation rates, costs, and resistance.

Main Results:

  • Of 157 patients with candidaemia, only 23 of 51 eligible patients underwent de-escalation to fluconazole.
  • Nine patients received unjustified step-up therapy, incurring an additional cost of €211,837.
  • Resistant strains of Candida species (1 C. albicans, 2 C. glabrata) were identified.

Conclusions:

  • A multidisciplinary team can limit advanced antifungal agent use and guide de-escalation, reducing costs and potentially curbing resistance.
  • Antifungal stewardship programs are essential for optimizing therapy and combating resistance.