Taynton, Thomas, Allsup, David and Barlow, Gavin (2024) How can we optimize antifungal use and stewardship in the treatment of acute leukemia? Expert review of hematology. pp. 581-593. ISSN 1747-4094
Abstract
INTRODUCTION: The global need for antifungal stewardship is driven by spreading antimicrobial and antifungal resistance. Triazoles are the only oral and relatively well-tolerated class of antifungal medications, and usage is associated with acquired resistance and species replacement with intrinsically resistant organisms. On a per-patient basis, hematology patients are the largest inpatient consumers of antifungal drugs, but are also the most vulnerable to invasive fungal disease. AREAS COVERED: In this review we discuss available and forthcoming antifungal drugs, antifungal prophylaxis and empiric antifungal therapy, and how a screening based and diagnostic-driven approach may be used to reduce antifungal consumption. Finally, we discuss components of an antifungal stewardship program, interventions that can be employed, and how impact can be measured. The search methodology consisted of searching PubMed for journal articles using the term antifungal stewardship plus program, intervention, performance measure or outcome before 1 January 2024. EXPERT OPINION: Initial focus should be on implementing effective antifungal stewardship programs by developing and implementing local guidelines and using interventions, such as post-prescription review and feedback, which are known to be effective. Technologies such as microbiome analysis and machine learning may allow the development of truly individualized risk-factor-based approaches to antifungal stewardship in the future.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2024 The Author(s). |
Keywords: | Humans,Antifungal Agents/therapeutic use,Antimicrobial Stewardship/methods,Drug Resistance, Fungal,Mycoses/drug therapy,Leukemia/drug therapy,Invasive Fungal Infections/drug therapy |
Dates: |
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Institution: | The University of York |
Academic Units: | The University of York > Faculty of Sciences (York) > Hull York Medical School (York) |
Depositing User: | Pure (York) |
Date Deposited: | 24 Sep 2024 13:30 |
Last Modified: | 16 Oct 2024 20:09 |
Published Version: | https://doi.org/10.1080/17474086.2024.2383401 |
Status: | Published online |
Refereed: | Yes |
Identification Number: | 10.1080/17474086.2024.2383401 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:217597 |
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Description: How can we optimize antifungal use and stewardship in the treatment of acute leukemia
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