Antifungal stewardship in solid‐organ transplantation: What is needed?. Issue 5 (18th October 2022)

• Record Type: Journal Article
• Authors: Whitney, Laura; Armstrong‐James, Darius; Lyster, Haifa S.; Reed, Anna K.; Dunning, John; Nwankwo, Lisa; Cheong, Jamie
• Other Names: Forrest Graeme guestEditor.; Husain Shahid guestEditor.
• Is Part Of: Transplant infectious disease. Volume 24:Issue 5(2023)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2022-10-18
• Subjects: antifungal stewardship -- fungal infections -- prescribing optimization -- solid‐organ transplantation; Transplantation of organs, tissues, etc -- Complications -- Periodicals; Communicable diseases -- Periodicals; Infection -- Periodicals; 617.01
• DOI: 10.1111/tid.13894
• Languages: English
• ISSNs: 1398-2273

Abstract

Abstract: Background: Antifungal stewardship (AFS) lags behind antimicrobial stewardship (AMS) in terms of implementation, evidence base, and workforce experience. Solid‐organ transplantation (SOT) carries a significant risk of invasive fungal infection, with high associated mortality, and is therefore associated with significant opportunities to optimize antifungal use. Methods: A literature search for the terms "antifungal stewardship" and "solid‐organ transplant" revealed a small evidence base to support AFS programs in this patient group. Results: There is significant overlap in the methodology used in AMS and AFS programs, with notable differences in diagnostics, which are discussed in detail. The primary AFS interventions tested in SOT recipients are implementation of clinical guidelines and care bundles, digital enablers of AFS, and post‐prescription review/audit and feedback. Conclusion: There is an urgent need for further research to support effective AFS strategies in this highly susceptible population.