METHODS: Articles were systematically reviewed using the PRISMA checklist 2020. EMBASE and MEDLINE/PubMED were searched using the term \"antifungal stewardship\" (2012-2022 data) on 2 January 2023. Eligible studies were those that described an AFS and included an intervention, performance evaluation and outcome measures.
RESULTS: A total of 22/796 studies were included. Approximately two-thirds (16) were published between 2018 and 2022. 16 (72.7%) stated a minimal complete AFS team. 12 (54.5%) adopted a non-compulsory AFS approach, 6(27.3%) had an Educational AFS and 4(18.2%) a compulsory AFS. Cost analyses of 12 studies showed a decrease for 7 (31.8%) compared to an increase for 5 (22.7%). In terms of outcomes, 18 studies showed a lower (10;45.5%) or the same (8;36.4%) pre-post intervention mortality rate.
CONCLUSIONS: AFS programs seem to be related to lower costs and better outcomes and should thus be implemented in tandem with antimicrobial stewardship programs.
方法:使用PRISMA清单2020对文章进行了系统审查。EMBASE和MEDLINE/PubMED于2023年1月2日使用术语“抗真菌管理”(2012-2022年数据)进行搜索。符合条件的研究是那些描述AFS并包括干预措施的研究,绩效评估和结果衡量标准。
结果:共纳入22/796项研究。大约三分之二(16)在2018年至2022年之间发布。16(72.7%)表示只有最少的完整AFS团队。12名(54.5%)采用非强制性AFS方法,6人(27.3%)有教育AFS,4人(18.2%)有强制性AFS。12项研究的成本分析显示,7项研究(31.8%)下降,5项研究增加(22.7%)。在结果方面,18项研究显示干预前死亡率较低(10;45.5%)或相同(8;36.4%)。
结论:AFS计划似乎与更低的成本和更好的结果有关,因此应与抗菌药物管理计划一起实施。