Wide lens, sharp focus: Antifungal stewardship from evidence to every pharmacist

Antifungal stewardship (AFS) is an evolving subspecialty of antimicrobial stewardship (AMS). This session will provide attendees with a view of AFS from global principles to local implementation, examining the key drivers, including rising antifungal resistance, expanding use of newer antifungal agents, and the challenges of managing high-risk immunocompromised patients. Australian data from recent national hospital surveys will frame the current scope and gaps in AFS across the country. The session will then translate these principles into practice, describing what AFS looks like in a tertiary hospital setting and the unique challenges of extending AFS into the outpatient context. A central theme will be the distinct and complementary roles of pharmacists across a hospital service, from infectious diseases and AMS pharmacists, to transplant, oncology, and outpatient pharmacists, and how collaboration between these groups can drive improvements in antifungal prescribing quality and patient safety.

This presentation will address the following learning objectives:

• Define AFS and describe the key components of an effective hospital AFS program, including the drivers for its implementation
• Outline the current state of AFS in Australian hospitals and identify priority targets for improvement
• Describe pharmacist-led AFS models in a tertiary hospital setting, including post-prescription audit and feedback, therapeutic drug monitoring-guided dosing, and the challenges involved
• Explain the distinct roles of infectious diseases, AMS, transplant, oncology, critical care and outpatient pharmacists within an AFS program, and the value of cross-specialty pharmacist collaboration