The increasing problem of treatment-resistant fungal infections: a call for antifungal stewardship programs

Area of Science:

• Public Health
• Infectious Diseases
• Pharmacology

Background:

• Antimicrobial stewardship (AMS) programs are established globally, primarily targeting bacterial infections and antibiotic resistance.
• However, a significant gap exists in the inclusion of antifungal stewardship (AFS) within these programs.
• Rising rates of fungal infections and diagnostic challenges contribute to antifungal overuse.

Purpose of the Study:

• To highlight the critical need for integrating antifungal stewardship (AFS) into existing antimicrobial stewardship (AMS) frameworks.
• To underscore the growing problem of antifungal resistance driven by increased exposure to antifungal agents.
• To advocate for global recognition and implementation of AFS programs.

Main Methods:

• Literature review on current AMS practices and antifungal resistance trends.
• Analysis of the incidence and impact of fungal infections.
• Synthesis of evidence supporting the necessity of AFS.

Main Results:

• Antifungal stewardship is underrepresented in global AMS initiatives.
• Increased antifungal use correlates with the emergence of antifungal resistance.
• Reports of treatment failures due to resistant fungal infections are mounting.

Conclusions:

• Antifungal stewardship (AFS) is an essential, emerging component of antimicrobial stewardship (AMS).
• There is a growing body of evidence necessitating the development and global adoption of AFS programs.
• AFS requires urgent attention to address the increasing threat of antifungal resistance.