Antifungal Stewardship Task Shifting Required of Pharmacists

Abstract

Similar to antimicrobial stewardship, the concept of antifungal stewardship (AFS) has also received attention. AFS outcomes include reduced healthcare costs, avoidance of adverse events, and increased implementation of therapeutic drug monitoring (TDM). Several processes and outcome measures have recently been reported for implementing AFS and evaluating its effectiveness in healthcare institutions. This review focuses on our AFS efforts to standardize treatment using a template for pharmacist-led patient intervention for candidemia and to evaluate TDM dosage adequacy rates for voriconazole. The importance of "task shifting", in which the physician's work is transferred or shared with pharmacists and other co-medical staff to alleviate concentration of physician workload, has also been advocated. This review focuses on how pharmacists are involved in AFS.

Assessing the impact of an electronic therapeutic drug monitoring record in the management of vancomycin through pharmacist intervention: a single‐centre study

“…Ebihara et al. reported similar challenges in human resources while implementing a template to standardise and evaluate voriconazole TDM 9 . However, it was reported that a standardised template steadily increased the number of pharmacists documenting interventions 9 .…”

“…Ebihara et al reported similar challenges in human resources while implementing a template to standardise and evaluate voriconazole TDM. 9 However, it was reported that a standardised template steadily increased the number of pharmacists documenting interventions. 9 Another study found that developing simple auto-text tools improved the productivity of pharmacists when working with EMR systems.…”

“…9 However, it was reported that a standardised template steadily increased the number of pharmacists documenting interventions. 9 Another study found that developing simple auto-text tools improved the productivity of pharmacists when working with EMR systems. This is reflective of an increase in pharmacist involvement in TDM in our study.…”

Evaluation of Systemic Antifungal Use in a Latin American General Care Hospital: A Retrospective Study

“…However, with increasing concerns about the emergence of antifungal resistance, there is a growing consideration in many countries to incorporate Antifungal Stewardship (AFS) into existing stewardship programs. This approach aims to address issues hindering the appropriate use of antifungal drugs and optimize their utilization [ 10 , 11 ].…”

“…Since pharmacists play many roles in AFS, including drug selection, dose and dosage, confirmation of treatment duration, and therapeutic drug monitoring, this study aims to assess the use of systemic antifungals at Hospital Clínica Biblica (HCB) and to determine whether comorbidities and risk factors in patients receiving systemic antifungals may be associated with the development of more serious fungal infections, in order to facilitate the implementation of a hospital policy that allows for the best possible use of these medications and, consequently, yields the best clinical results associated with its use [ 10 ].…”