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The Current State of Antifungal Stewardship in Immunocompromised Populations
William Alegria1,2, Payal K Patel3,4
1Department of Quality, Patient Safety and Effectiveness, Stanford Health Care, 300 Pasteur Drive, Lane 134 L1C36, Stanford, CA 94305, USA.
Abstract:
Inappropriate antifungal use is prevalent and can lead to drug-resistant fungi, expose patients to adverse drug events, and increase healthcare costs. While antimicrobial stewardship programs have traditionally focused on antibiotic use, the need for targeted antifungal stewardship (AFS) intervention has garnered interest in recent years. Despite this, data on AFS in immunocompromised patient populations is limited. This paper will review the current state of AFS in this complex population and explore opportunities for multidisciplinary collaboration.
Insights
Antifungal stewardship programs combat inappropriate antifungal use, drug resistance, and healthcare costs. This review focuses on antifungal stewardship in immunocompromised patients, highlighting limited data and the need for collaboration.
Area of Science:
- Medical Mycology
- Infectious Diseases
- Antimicrobial Stewardship
Background:
- Inappropriate antifungal use contributes to antifungal resistance, adverse drug events, and increased healthcare expenses.
- Antimicrobial stewardship programs (ASPs) traditionally focus on antibiotics, but antifungal stewardship (AFS) is gaining attention.
- Limited data exists on AFS interventions specifically within immunocompromised patient populations.
Purpose of the Study:
- To review the current landscape of antifungal stewardship (AFS) in immunocompromised patients.
- To identify challenges and opportunities for implementing AFS in this vulnerable group.
- To emphasize the importance of multidisciplinary collaboration for effective AFS.
Main Methods:
- Literature review of existing studies on antifungal stewardship.
- Analysis of AFS practices in immunocompromised patient cohorts.
- Exploration of collaborative models for AFS implementation.
Main Results:
- Prevalence of inappropriate antifungal prescribing in immunocompromised patients.
- Identification of key barriers to effective AFS in this population.
- Examples of successful multidisciplinary AFS initiatives.
Conclusions:
- Targeted antifungal stewardship is crucial for managing infections in immunocompromised patients.
- Multidisciplinary collaboration is essential for optimizing AFS and improving patient outcomes.
- Further research is needed to expand the evidence base for AFS in complex patient populations.
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