Evidence map›Paper›PMID 39741653›Full record

ArticleJAC-antimicrobial resistance2025

Antifungal stewardship in the UK: where are we now?

Silke Schelenz, Samir Agrawal, Aaron Brady, Gillian Kiely, Zeshan Riaz, Emilie Howes, Tim Felton, Christianne Micallef, Netta Tyler, Tihana Bicanic and 1 more

Abstract read
In one paragraph

Article in JAC-antimicrobial resistance, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Silke SchelenzSchool of Immunology & Microbial Sciences, Kings College London, London, UK.
Samir AgrawalHaemato-Oncology, Barts Health NHS Trust, London, UK.
Aaron BradySchool of Pharmacy, Queen's University Belfast, Belfast BT9 7BL, UK.
Gillian KielyPfizer Ltd, Speciality Care BU, Tadworth, Surrey, UK.ORCID https://orcid.org/0000-0002-4991-5151
Zeshan RiazPfizer Ltd, Speciality Care BU, Tadworth, Surrey, UK.
Emilie HowesPfizer Ltd, Speciality Care BU, Tadworth, Surrey, UK.
Tim FeltonDivision of Immunology, Immunity to Infection and Respiratory Medicine, The University of Manchester, Manchester, UK.
Christianne MicallefSchool of Pharmacy, University of East Anglia, Norwich, UK.
Netta TylerPharmacy Department, Cambridge University Hospitals, Cambridge CB2 0QQ, UK.
Tihana BicanicInstitute of Infection and Immunity, City St George's University of London, London SW17 0RE, UK.ORCID https://orcid.org/0000-0002-2676-838X
P Lewis WhitePublic Health Wales Mycology Reference Laboratory, UHW, Heath Park, Cardiff CF14 4XW, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Antifungal stewardship (AFS) is the judicious use of today's antifungal agents with the aim of improving patient outcomes and preserving their future effectiveness. Antifungal resistance (AFR) is increasing globally, with more patients at risk of Invasive Fungal Disease (IFD), highlighting the urgent need to standardize AFS practices in the UK. The aim of this position paper is to understand the current AFS landscape in the UK. Methods: A virtual panel discussion was held from September to October 2023 on an online platform followed by a virtual meeting with nine healthcare professionals from across the UK selected for their expertise on IFD management and AFS. The discussion was structured across four topics: current AFS landscape, key elements of an AFS programme, diagnostics and diagnostic stewardship, and unmet needs in education and training. A thematic analysis was carried out. The results represent the collated and summarized views from these activities. Results and discussion: Participants reported barriers to implementing AFS and its integration within antimicrobial stewardship (AMS) programmes in the UK. The primary challenge identified was a lack of resources, including funding and staff time. Sub-optimal fungal diagnostics and limited mycology expertise was reported as a barrier to AFS, clinical IFD and AFR surveillance. Approaches to combatting these challenges may include investing in formal mycology networks to serve as centres of clinical expertise and diagnostic hubs. Conclusion: National standards for AFS services and associated outcome metrics need to be established to set a benchmark for centres to improve AFS.

Identifiers

PMID39741653
PMCPMC11685713

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.