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Transpl Infect Dis ; 24(5): e13894, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36254506

RESUMO

BACKGROUND: Antifungal stewardship (AFS) lags behind antimicrobial stewardship (AMS) in terms of implementation, evidence base, and workforce experience. Solid-organ transplantation (SOT) carries a significant risk of invasive fungal infection, with high associated mortality, and is therefore associated with significant opportunities to optimize antifungal use. METHODS: A literature search for the terms "antifungal stewardship" and "solid-organ transplant" revealed a small evidence base to support AFS programs in this patient group. RESULTS: There is significant overlap in the methodology used in AMS and AFS programs, with notable differences in diagnostics, which are discussed in detail. The primary AFS interventions tested in SOT recipients are implementation of clinical guidelines and care bundles, digital enablers of AFS, and post-prescription review/audit and feedback. CONCLUSION: There is an urgent need for further research to support effective AFS strategies in this highly susceptible population.


Assuntos
Gestão de Antimicrobianos , Infecções Fúngicas Invasivas , Transplante de Órgãos , Antifúngicos/uso terapêutico , Gestão de Antimicrobianos/métodos , Humanos , Infecções Fúngicas Invasivas/diagnóstico , Infecções Fúngicas Invasivas/tratamento farmacológico , Infecções Fúngicas Invasivas/prevenção & controle , Transplante de Órgãos/efeitos adversos , Transplante de Órgãos/métodos , Transplantados
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