PDF(Pubmed)
Abstract：
In recent years, global public health efforts have increasingly emphasized the critical role of antimicrobial stewardship (AMS) in improving outcomes, reducing costs, and combating the growing threat of antimicrobial resistance. However, antifungal stewardship (AFS) has remained relatively overlooked despite the staggering impact of invasive fungal infections (IFIs). This burden is particularly pronounced in hospitals worldwide, with the Middle East facing significant unmet needs. The rising population of immunocompromised individuals vulnerable to IFI has prompted an increased reliance on antifungal agents for both prevention and treatment. Given the considerable mortality associated with IFIs and the emergence of antifungal resistance, implementing AFS programs in hospital settings is becoming increasingly urgent. In this article, we offer expert insights into the strategies that can be used for successful antifungal stewardship program implementation in IFI. Drawing upon the extensive clinical experience of a multinational and multidisciplinary panel, we present recommendations for optimizing AFS practices. We delve into the challenges and practical considerations of tailoring local AFS initiatives to the evolving landscape of fungal infections. Additionally, we provide actionable recommendations and position statements for the effective implementation of AFS programs, informed by the collective clinical experiences of panel members across their respective countries of practice.
摘要：
近年来,全球公共卫生工作越来越强调抗菌药物管理（AMS）在改善结果方面的关键作用，降低成本,和对抗日益增长的抗菌素耐药性威胁。然而,尽管侵袭性真菌感染(IFIs)的影响惊人,但抗真菌管理(AFS)仍然相对被忽视.这种负担在世界各地的医院尤其明显，中东面临着巨大的未满足的需求。越来越多的免疫功能低下的个体易患IVI，这促使人们越来越依赖抗真菌药物进行预防和治疗。考虑到与IFIs相关的相当大的死亡率和抗真菌耐药性的出现，在医院环境中实施AFS计划变得越来越紧迫。在这篇文章中,我们提供了专家见解，以了解可用于成功实施的抗真菌药物管理计划的策略。借鉴跨国和多学科小组的丰富临床经验，我们提出了优化AFS实践的建议。我们深入研究了针对真菌感染不断变化的景观定制本地AFS计划的挑战和实际考虑。此外,我们为有效实施AFS计划提供可操作的建议和立场声明，由各自国家的专家小组成员的集体临床经验提供信息。
