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Related Experiment Video

Updated: Feb 27, 2026

An Ex vivo Assay to Study Candida albicans Hyphal Morphogenesis in the Gastrointestinal Tract
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Optimizing Antifungal Use Through Interdisciplinary Intervention in the Hematology Unit.

Maria Alejandra Caro Flautero1,2,3, Maria Camila Rubio2, Edgar Fabián Manrique-Hernández2

  • 1Department of Immunology, Microbiology and Parasitology, Faculty of Medicine and Nursing, University of the Basque Country (UPV/EHU), Bizkaia Campus, 48940 Leioa, Spain.

Journal of Fungi (Basel, Switzerland)
|February 26, 2026
PubMed
Summary

An antifungal stewardship program in Colombia optimized antifungal use in hematology patients. The intervention shifted prescribing to prophylaxis, reduced broad-spectrum drug use, and proved safe and feasible in a middle-income setting.

Keywords:
antifungal agentsantimicrobial stewardshipcommunicable diseasesdrug utilization reviewhematology

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Area of Science:

  • Infectious Diseases
  • Hematology
  • Pharmacology

Background:

  • Invasive fungal infections pose risks for immunocompromised patients with hematologic malignancies.
  • Challenges in Colombia include limited diagnostics, varied prescribing, and antifungal resistance.
  • Optimizing antifungal use is crucial in this patient population.

Purpose of the Study:

  • To evaluate an interdisciplinary antifungal stewardship intervention in a hospital's hematology unit.
  • To assess the impact of stewardship on prescribing patterns, consumption, and patient outcomes.
  • To determine the feasibility and safety of such programs in middle-income countries.

Main Methods:

  • A quasi-experimental before-and-after study design.
  • Inclusion of 353 hospitalized patients receiving systemic antifungals.
  • Analysis of 1154 antifungal prescriptions before and after the intervention.

Main Results:

  • Shift towards increased antifungal prophylaxis and reduced therapeutic use.
  • Reduced dosing of prophylactic Amphotericin B and decreased voriconazole use.
  • No significant changes in ICU admissions or in-hospital mortality; costs shifted from treatment to prophylaxis.

Conclusions:

  • Structured antifungal stewardship programs are feasible and safe in hematology units in middle-income settings.
  • The intervention supported more rational antifungal use without negatively impacting patient outcomes.
  • Stewardship can help address challenges of limited diagnostics and resistance in resource-constrained environments.