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Implementation of Effective Antifungal Stewardship in Cancer Patients—A Review of Current Evidence

  • Current Management of Fungal Infections (S Jacobs, Section Editor)
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Abstract

Purpose of Review

This review summarizes the literature around antifungal stewardship (AFS) with a focus on the cancer setting. We include a review of identified challenges to the implementation of AFS, summarize studies evaluating quality of prescribing and interventions to optimize invasive fungal disease management. We also provide a review of metrics for AFS programs and advances in fungal diagnostics which can be harnessed by the AFS team.

Recent Findings

In recent times, there has been an increase in targeted research assessing the quality of antifungal prescribing and the impact of AFS interventions, largely within single centers and observational in nature.

Summary

Several challenges exist to the implementation of AFS programs. Studies have found high rates of suboptimal antifungal prescribing, and multifaceted interventions have been successful in optimizing the quality and reducing the volume of prescribing. Standardized metrics may assist hospitals to interpret data effectively and structure suitable quality improvement programs.

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Authors and Affiliations

  1. The National Centre for Infections in Cancer, Peter MacCallum Cancer Centre, Level 13 North, 305 Grattan St, Melbourne, Victoria, 3000, Australia

    Anna Khanina, Abby P. Douglas & Karin A. Thursky

  2. Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Victoria, Australia

    Anna Khanina, Abby P. Douglas & Karin A. Thursky

  3. Department of Infectious Diseases, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia

    Abby P. Douglas & Karin A. Thursky

  4. The National Centre for Antimicrobial Stewardship, The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia

    Karin A. Thursky

  5. Department of Medicine, University of Melbourne, Parkville, Victoria, Australia

    Karin A. Thursky

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  1. Anna Khanina
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Correspondence to Anna Khanina.

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Conflict of Interest

Anna Khanina reports grants from National Health and Medical Research Council (NHMRC) during the conduct of the study. Abby Douglas reports grants from Gilead outside the submitted work. Karin Thursky reports grants from National Health and Medical Research Council (NHMRC) during the conduct of the study.

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Khanina, A., Douglas, A.P. & Thursky, K.A. Implementation of Effective Antifungal Stewardship in Cancer Patients—A Review of Current Evidence. Curr Fungal Infect Rep 14, 361–372 (2020). https://doi.org/10.1007/s12281-020-00408-0

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  • DOI: https://doi.org/10.1007/s12281-020-00408-0

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