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AMSAMSAn introduction to antimicrobial stewardshipStewardshipSurveillanceRace against resistanceABSABSABS in practice Educational ResourcesAFSAFSShape the futureAFS in practiceImplementing an AFS programmeDiagnosticsGuidelinesCase studiesAll case studiesOur CommitmentOur CommitmentOur commitment to anti-infectivesHeritageSustainability
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Information on how to access prescribing information and adverse event reporting can be found at the bottom of the page.

Implementing an AFS programme

It’s vital that we act now to protect tomorrow – the future of antifungal resistance is in our hands. One way to take action is with an antifungal stewardship programme: a type of specialist intervention aimed at optimising the care of patients with invasive fungal infections.1,2 

Stewardship programmes have largely focused on antibacterial rather than antifungal use1,2

In a survey of acute NHS Trusts, only 11% (5/47) reported having a dedicated AFS programme, compared to 98% with an ABS programme.1,2

NHS England antifungal spend is over £80 million per annum.3 With an AFS programme, drug costs can be reduced while patient outcomes can be improved: estimates suggest an overall financial opportunity of £4–8 million per annum.2,3

Aside from the potential value benefit, putting measures in place can help to protect the future. Stewardship programmes can be effective in reducing inappropriate antifungal use and limiting emerging resistance.1,2 

A successful AFS programme can help to develop guidelines, protocols, and best-practice guidance.4 Day to day, an AFS programme can form a part of regular audits, staff surveys, educational initiatives, ward rounds, and multidisciplinary team (MDT) meetings, helping to build on pre-existing management strategies and establish AFS ‘champions’, i.e., individuals with the relevant expertise to influence clinical practice.4,5

Building your team

There is not yet a national consensus on AFS strategy aside from following local guidance for managing invasive fungal infections.4 However, putting measures in place today can help to protect antifungal use and forge a new path for the future. 

The first step for many in developing their own AFS programme is to establish an MDT that can support decision-making, bringing together expertise for the management of invasive fungal infections.4,5 Your team might include clinical pharmacists, microbiologists, infectious diseases specialists, and haematologists. Core members should have knowledge of and experience in:1,4–6

  • Clinical management of relevant patient populations
  • Fungal epidemiology and susceptibility patterns
  • Laboratory diagnosis of invasive fungal infections
  • Pharmacokinetics and interactions of antifungal drugs
  • Dosing
How an MDT can work together in an AFS programme5Ensuring effectiveness

Management of invasive fungal infections is complex, but having a multidisciplinary team in place could help your Trust to develop and implement AFS practices. Once you have set up your team you can get started with implementing an AFS programme by establishing prescribing guidelines, conducting initial audits and performing a diagnostics gap analysis.

Understanding regional guidelines Guidelines Loading Learn more about available diagnostic approaches Diagnostics Loading

A successful AFS programme requires continued surveillance of fungal infections, optimised diagnostics (including access and screening), and appropriate treatment choices. Doing so can help to reduce resistance, minimise bed stay, prevent unnecessary exposure to antifungals, and improve value.4 Different hospitals and regions have employed their own AFS strategies – taking note of successful examples can help to optimise your own AFS programme for your Trust.

Examples of successful AFS programmes Case studies LoadingExplore more
Shape the future (AFS) Getting started with an AFS programme in your Trust DownloadLoading Explore examples of successful AFS programmes Read more Loading
Available approaches for management DiagnosticsLoading

ABS, antibacterial stewardship; AFS, antifungal stewardship; AMS, antimicrobial stewardship; MDT, multidisciplinary team;
NHS, National Health Service; TDM, therapeutic drug monitoring.

Prescribing Information:
Click here for CRESEMBA® (isavuconazole) prescribing information

References:

Micallef C et al. J Med Microbiol 2017;66(11):1581–1589.NHS England Antifungal Stewardship Implementation Pack. Available at: https://www.england.nhs.uk/wp-content/uploads/2019/03/PSS1-meds-optimisation-trigger-5-antifungal-stewardship-implementation-pack.pdf. Accessed August 2022.NHS 2019/21 PSS CQUIN Scheme Indicator Template. Available at: https://www.england.nhs.uk/wp-content/uploads/2019/03/PSS1-Meds-Optimisation-CQUIN-1920-Indicator.pdf. Accessed August 2022.Talento AF et al. J Fungi 2021;7:801. https://doi.org/10.3390/jof7100801.Agrawal S et al. J Antimicrob Chemother 2016;71(Suppl 2):ii37–ii42.Whitney L et al. J Antimicrob Chemother 2019;74(1):234–241.
PP-CRB-GBR-1637. August 2022.

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

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