Antifungal stewardship in the UK: where are we now?

Silke Schelenz, Samir Agrawal, Aaron Brady, Gillian Kiely, Zeshan Riaz, Emilie Howes, Tim Felton, Christianne Micallef, Netta Tyler, Tihana Bicanic, P Lewis White

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: Antifungal stewardship (AFS) is the judicious use of today's antifungal agents with the aim of improving patient outcomes and preserving their future effectiveness. Antifungal resistance (AFR) is increasing globally, with more patients at risk of Invasive Fungal Disease (IFD), highlighting the urgent need to standardize AFS practices in the UK. The aim of this position paper is to understand the current AFS landscape in the UK.

METHODS: A virtual panel discussion was held from September to October 2023 on an online platform followed by a virtual meeting with nine healthcare professionals from across the UK selected for their expertise on IFD management and AFS. The discussion was structured across four topics: current AFS landscape, key elements of an AFS programme, diagnostics and diagnostic stewardship, and unmet needs in education and training. A thematic analysis was carried out. The results represent the collated and summarized views from these activities.

RESULTS AND DISCUSSION: Participants reported barriers to implementing AFS and its integration within antimicrobial stewardship (AMS) programmes in the UK. The primary challenge identified was a lack of resources, including funding and staff time. Sub-optimal fungal diagnostics and limited mycology expertise was reported as a barrier to AFS, clinical IFD and AFR surveillance. Approaches to combatting these challenges may include investing in formal mycology networks to serve as centres of clinical expertise and diagnostic hubs.

CONCLUSION: National standards for AFS services and associated outcome metrics need to be established to set a benchmark for centres to improve AFS.

Original languageEnglish
Article numberdlae209
JournalJAC-Antimicrobial Resistance
Volume7
Issue number1
Early online date31 Dec 2024
DOIs
Publication statusPublished - 1 Feb 2025

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