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Updated: Jun 17, 2026

Live Imaging of Antifungal Activity by Human Primary Neutrophils and Monocytes in Response to A. fumigatus
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Antifungal stewardship in the UK: where are we now?

Silke Schelenz1, Samir Agrawal2,3, Aaron Brady4,5

  • 1School of Immunology & Microbial Sciences, Kings College London, London, UK.

Jac-Antimicrobial Resistance
|January 1, 2025
PubMed
Abstract

Insights

Antifungal stewardship (AFS) in the UK faces challenges due to limited resources and diagnostic expertise. Establishing national standards is crucial for improving patient outcomes and combating antifungal resistance (AFR).

Area of Science:

  • Medical Mycology
  • Infectious Diseases
  • Antimicrobial Stewardship

Background:

  • Rising global antifungal resistance (AFR) necessitates improved Invasive Fungal Disease (IFD) management.
  • Antifungal stewardship (AFS) is vital for optimizing antifungal agent use and preserving efficacy.
  • Standardizing AFS practices in the UK is an urgent priority.

Purpose of the Study:

  • To assess the current landscape of Antifungal Stewardship (AFS) in the United Kingdom.
  • To identify key challenges and opportunities for AFS implementation and integration within Antimicrobial Stewardship (AMS) programmes.

Main Methods:

  • A virtual panel discussion and meeting were conducted with nine UK-based IFD and AFS experts.
  • Discussions covered the current AFS landscape, programme elements, diagnostics, and training needs.
  • Thematic analysis was used to summarize expert views.

Main Results:

  • Key barriers to AFS implementation include lack of funding and staff time.
  • Sub-optimal fungal diagnostics and limited mycology expertise hinder AFS and surveillance efforts.
  • Developing formal mycology networks is proposed to enhance expertise and diagnostics.

Conclusions:

  • National standards and outcome metrics for AFS services are needed.
  • Establishing benchmarks will drive improvements in AFS across UK centres.
  • Addressing resource and expertise gaps is critical for effective AFS.

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