Antifungal Stewardship Task Shifting Required of Pharmacists

Similar to antimicrobial stewardship, the concept of antifungal stewardship (AFS) has also received attention. AFS outcomes include reduced healthcare costs, avoidance of adverse events, and increased implementation of therapeutic drug monitoring (TDM). Several processes and outcome measures have recently been reported for implementing AFS and evaluating its effectiveness in healthcare institutions. This review focuses on our AFS efforts to standardize treatment using a template for pharmacist-led patient intervention for candidemia and to evaluate TDM dosage adequacy rates for voriconazole. The importance of "task shifting", in which the physician's work is transferred or shared with pharmacists and other co-medical staff to alleviate concentration of physician workload, has also been advocated. This review focuses on how pharmacists are involved in AFS.