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Core Recommendations for Antifungal Stewardship: A Statement of the Mycoses Study Group Education and Research

Melissa D Johnson1, Russell E Lewis2, Elizabeth S Dodds Ashley1

  • 1Division of Infectious Diseases and International Health, Duke University Medical Center, Durham, North Carolina, USA.

The Journal of Infectious Diseases
|August 7, 2020
PubMed

Insights

Antifungal stewardship (AFS) is crucial for improving patient outcomes and combating resistance. This emerging component of antimicrobial stewardship requires specific recommendations beyond general guidelines due to unique challenges in fungal infections.

Area of Science:

  • Infectious Diseases
  • Public Health
  • Clinical Pharmacy

Background:

  • Antimicrobial stewardship (AMS) is vital for improving patient outcomes, reducing healthcare costs, and combating antimicrobial resistance.
  • Antifungal stewardship (AFS) has received less attention despite the growing threat of fungal infections and resistance.
  • General AMS principles may apply to AFS, but unique aspects of fungal infections necessitate specialized recommendations.

Purpose of the Study:

  • To review existing literature on AMS best practices.
  • To discuss antifungal stewardship (AFS) within the framework of global AMS core elements.
  • To provide evidence-based recommendations for best practices in AFS.

Main Methods:

  • Literature review of antimicrobial stewardship (AMS) best practices.
  • Analysis of antifungal stewardship (AFS) through the lens of global AMS core elements.
  • Synthesis of evidence by an interdisciplinary expert panel from the Mycoses Study Group Education and Research Consortium.

Main Results:

  • AFS is an emerging and critical component of overall antimicrobial stewardship.
  • Specific considerations for AFS include expertise, education, optimization of antifungal utilization, therapeutic drug monitoring, and data analysis.
  • Recommendations for AFS best practices were developed based on expert consensus and evidence synthesis.

Conclusions:

  • Antifungal stewardship (AFS) requires tailored strategies beyond general antimicrobial stewardship (AMS) guidelines.
  • Addressing unique challenges in fungal infections is essential for effective AFS.
  • Further research is needed in this rapidly evolving field to refine AFS practices.
Keywords:
antifungalaspergillosiscandidiasisdiagnosticsguidelinesstewardship

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