Department of Infection Control Science, Graduate School of Medicine, Osaka Metropolitan University.
Department of Infection Control and Prevention, Osaka Metropolitan University Hospital.
Med Mycol J. 2024;65(2):33-38. doi: 10.3314/mmj.24.003.
Antifungal stewardship (AFS), compared with antimicrobial stewardship (AS), requires more advanced knowledge, skills, and multidisciplinary collaboration in its implementation. Therefore, fewer facilities are performing AFS compared with AS. At our hospital, we started AS and AFS in 2014. Our AFS programs include the following: i) interventions for patients with yeast-positive blood cultures, ii) introduction of a conditional antifungal notification system, and iii) commencement of AS team rounds. AFS for filamentous fungi includes bronchoscopy and microbial identification, including genetic and drug susceptibility testing. These AFS activities have improved several processes and outcome measures. However, our AFS team has faced several problems owing to the impact of COVID-19. This review introduces the practice of AFS, which we initiated at our hospital in 2014, and presents the current problems.
抗真菌药物管理（AFS）与抗菌药物管理（ASM）相比，在实施过程中需要更先进的知识、技能和多学科协作。因此，与 ASM 相比，实施 AFS 的医疗机构较少。在我们医院，我们于 2014 年开始实施 ASM 和 AFS。我们的 AFS 计划包括：i）对酵母菌血培养阳性患者进行干预，ii）引入条件性抗真菌药物通知系统，以及 iii）启动 ASM 团队查房。丝状真菌的 AFS 包括支气管镜检查和微生物鉴定，包括基因和药敏试验。这些 AFS 活动改善了多个流程和结果指标。然而，由于 COVID-19 的影响，我们的 AFS 团队面临了一些问题。本综述介绍了我们 2014 年在医院开展的 AFS 实践，并提出了当前存在的问题。
