Antifungal stewardship in the UK: where are we now?

IF 3.7 Q2 INFECTIOUS DISEASES
JAC-Antimicrobial Resistance Pub Date : 2024-12-31 eCollection Date: 2025-02-01 DOI:10.1093/jacamr/dlae209
Silke Schelenz, Samir Agrawal, Aaron Brady, Gillian Kiely, Zeshan Riaz, Emilie Howes, Tim Felton, Christianne Micallef, Netta Tyler, Tihana Bicanic, P Lewis White
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引用次数: 0

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.

英国的抗真菌管理:我们现在在哪里?
背景:抗真菌管理(AFS)是明智地使用当今的抗真菌药物,目的是改善患者的预后并保持其未来的有效性。抗真菌耐药性(AFR)在全球范围内不断增加,越来越多的患者面临侵袭性真菌疾病(IFD)的风险,这凸显了英国对AFS实践标准化的迫切需要。本立场文件的目的是了解当前AFS在英国的格局。方法:于2023年9月至10月在在线平台上举行虚拟小组讨论,随后与来自英国各地的9名医疗保健专业人员进行虚拟会议,这些专业人员在IFD管理和AFS方面获得了专业知识。讨论围绕四个主题展开:AFS的现状、AFS计划的关键要素、诊断和诊断管理,以及教育和培训方面未满足的需求。进行了专题分析。结果是对这些活动的观点进行整理和总结的结果。结果和讨论:与会者报告了在英国实施AFS及其与抗菌药物管理(AMS)计划整合的障碍。确定的主要挑战是缺乏资源,包括资金和工作人员时间。据报道,不理想的真菌诊断和有限的真菌学专业知识是AFS,临床IFD和AFR监测的障碍。应对这些挑战的方法可能包括投资于正式的真菌学网络,作为临床专业知识中心和诊断中心。结论:需要建立AFS服务和相关结果指标的国家标准,为中心改善AFS设置基准。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
5.30
自引率
0.00%
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审稿时长
16 weeks
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