f An investigation of antifungal stewardship programmes in England
- Authors: Christianne Micallef1 , Diane Ashiru-Oredope2 , Sejal Hansraj2 , David W. Denning3 , Samir G. Agrawal4 , Rohini J. Manuel5 , Silke Schelenz6 , Rebecca Guy7 , Berit Muller-Pebody7 , Rakhee Patel8 , Philip Howard9 , Susan Hopkins7 , Elizabeth Johnson10 , David A. Enoch11
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1 1Pharmacy Department, Addenbrooke’s Hospital, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke’s Hospital Biomedical Campus, Hills Road, Cambridge CB2 0QQ, UK 2 2Antimicrobial Resistance Programme, Public Health England, 61 Colindale Avenue, London NW9 5EQ, UK 3 3National Aspergillosis Centre, University Hospital of South Manchester, The University of Manchester and Manchester Academic Health Science Centre, Manchester, UK 4 4Bart’s Health NHS Trust and Blizard Institute, Queen Mary University of London, London, UK 5 5National Infection Service, Public Health England, Public Health Laboratory London, London, UK 6 6Royal Brompton Hospital & Harefield Hospitals NHS FT, Sydney Street, London SW3 6NP, UK 7 7Healthcare Associated Infection and Antimicrobial Resistance Department, National Infection Service, Public Health England, 61 Colindale Avenue, London, UK 8 8Pharmacy Department, Darent Valley Hospital, Dartford and Gravesham NHS Trust, Darenth Wood Road, Dartford, Kent DA2 8DA, UK 9 9Pharmacy Department, Leeds Teaching Hospitals NHS Trust, Leeds, UK 10 10Public Health England South West Laboratory, Myrtle Road, Kingsdown, Bristol BS2 8EL, UK 11 11National Infection Service, Public Health England, Microbiology Laboratory, Addenbrook's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
- *Correspondence: David A. Enoch [email protected]
- First Published Online: 25 October 2017, Journal of Medical Microbiology 66: 1581-1589, doi: 10.1099/jmm.0.000612
- Subject: Clinical Microbiology
- Received:
- Accepted:
- Cover date:
An investigation of antifungal stewardship programmes in England, Page 1 of 1
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Purpose. We sought to explore the current status of antifungal stewardship (AFS) initiatives across National Health Service (NHS) Trusts within England, the challenges and barriers, as well as ways to improve current AFS programmes.
Methodology. An electronic survey was sent to all 155 acute NHS Trusts in England. A total of 47 Trusts, corresponding to 30 % of English acute Trusts, responded to the the survey; 46 Trusts (98 %) had an antimicrobial stewardship (AMS) programme but only 5 (11 %) had a dedicated AFS programme. Overall, 20 (43 %) Trusts said they included AFS as part of their AMS programmes. From those conducting AFS programmes, 7 (28 %) have an AFS/management team, 16 (64 %) monitor and report on antifungal usage, 5 (20 %) have dedicated AFS ward rounds and 12 (48 %) are directly involved in the management of invasive fungal infections.
Results/Key findings. Altogether, 13 acute Trusts (52 %) started their AFS programme to manage costs, whilst 12 (48 %) commenced the programme due to clinical need; 27 (73 %) declared that they would increase their AFS initiatives if they could. Of those without an AFS programme, 14 (67 %) responded that this was due to lack of resources/staff time. Overall, 12 Trusts (57 %) responded that the availability of rapid diagnostics and clinical support would enable them to conduct AFS activities.
Conclusion. Although a minority of Trusts conduct dedicated AFS programmes, nearly half include AFS as part of routine AMS activities. Cost issues are the main driver for AFS, followed by clinical need. The availability of rapid diagnostics and clinical support could help increase AFS initiatives.
- Keyword(s): stewardship, evaluation of antifungal practices, antifungal management, antifungal stewardship
© 2017 The Authors | Published by the Microbiology Society
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