ReviewTropical medicine and infectious disease2023
The Impact of Antifungal Stewardship on Clinical and Performance Measures: A Global Systematic Review.
Review in Tropical medicine and infectious disease, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
17 citing papers in PubMed.
- A review on fungal pathogens in the One Health framework: connecting plant, animal, and human health.Archives of microbiology · 2026Review
- Therapeutic Failure in Invasive Fungal Infections: Beyond Antifungal Resistance-A Narrative Review.Journal of fungi (Basel, Switzerland) · 2026Review
- Diagnostic Failure in Invasive Fungal Infections: Causes, Clinical Consequences, and Mitigation Strategies.Journal of fungi (Basel, Switzerland) · 2026Review
- Effect of polymerase chain reaction-based antifungal stewardship on candidemia management in small- and medium-sized hospitals.Journal of pharmaceutical health care and sciences · 2026Article
- Outcomes Following Antifungal Treatment forJournal of fungi (Basel, Switzerland) · 2026Article
- Optimizing Antifungal Use Through Interdisciplinary Intervention in the Hematology Unit.Journal of fungi (Basel, Switzerland) · 2026Article
- Irrational and Inappropriate Use of Antifungals in the NICU: A Narrative Review.Antibiotics (Basel, Switzerland) · 2026Review
- Assessing antifungal stewardship competency among pharmacy students: key findings and implications for clinical practice.Frontiers in public health · 2026Article
- Asymptomatic Candiduria due toCase reports in infectious diseases · 2026Article
- Antifungal resistance: Emerging mechanisms and implications (Review).Molecular medicine reports · 2025Review
- Antifungal Agents in the 21st Century: Advances, Challenges, and Future Perspectives.Infectious disease reports · 2025Review
- Antimicrobials in serious illness and end-of-life care: lifting the veil of silence.The Lancet. Infectious diseases · 2025Review
- Perspectives on the Use of Echinocandins in the Neonatal Intensive Care Unit.Antibiotics (Basel, Switzerland) · 2024Review
- Promoting antifungal stewardship through an antifungal multidisciplinary team in a paediatric and adult tertiary centre in the UK.JAC-antimicrobial resistance · 2024Article
- Guideline Adherence and Outcomes of Patients with Candidemia in Brazil.Journal of fungi (Basel, Switzerland) · 2024Article
- The top 10 papers on the treatment of invasive fungal infections, 2018-2023.Therapeutic advances in infectious diseaseArticle
- Management of invasive candidiasis in the ICU: Challenges and advances (Review).Medicine internationalReview
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAntimicrobial stewardship programs (ASP) have been proposed as an opportunity to optimize antifungal use. The antifungal resistance is a significant and emerging threat. The literature on antifungal stewardship (AFS) and its influence on performance and clinical outcome measures is scarce. This study aimed to examine global evidence of the impact of AFS on patients and performance measures.
methodsThe "Preferred Reporting Items for Systematic Reviews and Meta-Analyses" (PRISMA) was used for the flow of identification, screening, eligibility, and inclusion. PubMed and MEDLINE were searched using the term ''antifungal stewardship'' on 15 February 2023. Search terms included antifungal stewardship, antimicrobial stewardship, candida, candidemia, candiduria, and invasive fungal disease. Of the 1366 records, 1304 were removed since they did not describe an antifungal stewardship intervention. Among the 62 full texts assessed, 21 articles were excluded since they were non-interventional studies and did not include the outcome of interest. Thus, 41 articles were eligible for systematic review. Eligible studies were those that described an AFS program and evaluated clinical or performance measures.
resultsOf the 41 included studies, the primary performance measure collected was antifungal consumption (22 of 41), and mortality (22 of 41), followed by length of stay (11 of 41) and cost (9 of 41). Most studies were single-center, quasi-experimental, with varying interventions across studies. The principal finding from most of the studies in this systematic review is a reduction in mortality expressed in different units and the use of antifungal agents (13 studies out of 22 reporting mortality). Antifungal consumption was significantly blunted or reduced following stewardship initiation (10 of 22). Comparing studies was impossible due to a lack of standard units, making conducting a meta-analysis unfeasible, which would be a limitation of our study.
conclusionIt has been shown that AFS interventions may improve antifungal consumption and other performance measures. According to available published studies, antifungal consumption and mortality appear to be the possible performance measures to evaluate the impact of AFS.
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