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Information on how to access prescribing information and adverse event reporting can be found at the bottom of the page.

Antifungal stewardship (AFS) in practiceWhat is AFS and why do we need it?

Just as antibacterial stewardship (ABS) looks to ensure the appropriate use of antibiotics, AFS guides the use of antifungals in invasive fungal infections, to reduce unnecessary exposure and consumption while maintaining or improving outcomes.1

Resistance to antifungal drugs is not yet as common as that seen with antibacterial drugs, but it is a real clinical threat that requires shared action.2 By working together, we can shape the future. Optimising prevention and treatment is particularly important due to the high mortality associated with these infections, challenges in diagnosis, and the complexity of the drugs and patient groups involved.1,2 Implementing AFS tactics can help ensure that the right patients receive the right therapy at the right time. Let’s take the lead on antifungal stewardship.

Prevalence of invasive fungal infections

The burden of invasive fungal infections continues to grow, with increases in at-risk populations and incidence and no let-up in mortality rates.1,3–5

Estimated annual cases of invasive fungal infection in the UK3,a AFS programmes

There is currently no national consensus on AFS strategy,1 but a few simple initiatives can help Trusts to set up their own AFS programmes and put principles into practice. This could include creating a multi-disciplinary AFS team and conducting regular audits on antifungal usage. By taking steps like these, we have the opportunity to shape the future of antifungal stewardship.

Suggested elements of an AFS programme2
  1. Evidence based guidance
    Any healthcare professional administering high-cost antifungals should do so in line with the agreed guidelines for their Trust. Regional guidance can support Trusts in setting up local practices.
  2. AFS team reviews
    An AFS team is a central component to any effective AFS programme. Having a dedicated team in place can support with conducting regular reviews.
  3. Regular audits
    Audits can be a useful tool to capture and report the information gathered from reviews of antifungal prescribing.
  4. Diagnostics gap analysis
    Carrying out a diagnostics gap analysis of current practice against recommendations can identify opportunities for improvement.
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Shape the future (AFS) Learn more about AFS in practice DownloadLoading Understanding regional guidelines GuidelinesLoading
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a. For each fungal condition, the study considered which populations were most at risk, sought published estimates for incidence or prevalence measures for the fungal condition in these specific risk populations, and applied these rates to available published estimates of size of these high-risk populations in the UK (or certain countries within the UK where UK estimates were not available). Only the estimates for invasive aspergillosis explicitly included critical care patients.3

ABS, antibacterial stewardship; AFS, antifungal stewardship; AMS, antimicrobial stewardship; CQUIN, Commissioning for Quality and Innovation; NHS, National Health Service.

Prescribing Information:

Click here for CRESEMBA® (isavuconazole) prescribing information

References:

Talento AF et al. J Fungi 2021;7:801. https://doi.org/10.3390/jof7100801.NHS England. Antifungal Stewardship Implementation Pack. July 2019. Available at: https://www.england.nhs.uk/wp-content/uploads/2019/03/PSS1-meds-optimisation-trigger-5-antifungal-stewardship-implementation-pack-v7.pdf Accessed August 2022.Pegorie M et al. J Infect 2017;74(1):60–71.Natesan SK and Chandrasekar PH. Infect Drug Resist 2016;9:291–300.Perfect JR. Nat Rev Drug Discov 2017;16(9):603–616.UK Health Security Agency. English surveillance programme for antimicrobial utilisation and resistance (ESPAUR) Report 2020 to 2021. Available at:   https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1033851/espaur-report-2020-to-2021-16-Nov.pdf Accessed August 2022.
PP-CRB-GBR-1636. August 2022.

Adverse events should be reported. Reporting forms and information can be found at www.mhra.gov.uk/yellowcard or search 

for MHRA Yellow Card in Google Play or Apple App Store

 

Adverse events should also be reported to Pfizer Medical Information on 01304 616161

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