Antifungal Stewardship Considerations for Adults and Pediatrics.

TitleAntifungal Stewardship Considerations for Adults and Pediatrics.
Publication TypeJournal Article
Year of Publication2016
AuthorsHamdy RF, Zaoutis TE, Seo SK
JournalVirulence
Date Published2016 Sep 2
ISSN2150-5608
Abstract

Antifungal stewardship refers to coordinated interventions to monitor and direct the appropriate use of antifungal agents in order to achieve the best clinical outcomes and minimize selective pressure and adverse events. Antifungal utilization has steadily risen over time in concert with the increase in number of immunocompromised adults and children at risk for invasive fungal infections (IFI). Challenges in diagnosing IFI often lead to delays in treatment and poorer outcomes. There are also emerging data linking prior antifungal exposure and suboptimal dosing to the emergence of antifungal resistance, particularly for Candida. Antimicrobial stewardship programs can take a multi-pronged bundle approach to ensure suitable prescribing of antifungals via post-prescription review & feedback and/or prior authorization. Institutional guidelines can also be developed to guide diagnostic testing in at-risk populations; appropriate choice, dose, and duration of antifungal agent; therapeutic drug monitoring; and opportunities for de-escalation and intravenous-to-oral conversion.

DOI10.1080/21505594.2016.1226721
Alternate JournalVirulence
PubMed ID27588344