A Case for Antifungal Stewardship

Journal Article (Review;Journal)

Purpose of Review: The expanding utilization of limited available antifungal agents has led to a pressing need to implement interventions to ensure appropriate usage. The global emergence of resistant, difficult-to-treat invasive fungal infections among the most vulnerable patient populations is a call to action to develop a multifaceted antifungal stewardship approach. Recent Findings: Candida species demonstrating multi-drug resistance, including highly resistant Candida auris, are emerging threats. Azole-resistant Aspergillus fumigatus, likely initially originating in the environment, likewise presents a treatment challenge. Routine empiric and prophylactic antifungal use, though effective, further complicates this issue, with the emergence of breakthrough mold infections. Early evidence supports success with antifungal stewardship programs. Summary: Broad antifungal stewardship approaches that optimize antifungal drug usage, facilitate provider education, and monitor fungal epidemiology are crucial steps to preserve the antifungal armamentarium. Future development of novel diagnostic and treatment strategies will further facilitate management of invasive fungal infections.

Full Text

Duke Authors

Cited Authors

  • Miller, RA

Published Date

  • March 1, 2018

Published In

Volume / Issue

  • 12 / 1

Start / End Page

  • 33 - 43

Electronic International Standard Serial Number (EISSN)

  • 1936-377X

International Standard Serial Number (ISSN)

  • 1936-3761

Digital Object Identifier (DOI)

  • 10.1007/s12281-018-0307-z

Citation Source

  • Scopus