Antifungal Stewardship in Immunocompromised Hosts

Dear Colleagues,

Antifungal stewardship programs (AFSPs) are increasingly recognized as crucial components of antimicrobial stewardship in hospitals and healthcare systems. Their relevance is based on the rising burden of fungal infections, the emergence of new antifungal drugs and the challenges in diagnosing invasive fungal infections (IFIs).

In recent years, we have experienced an increase in IFIs, especially in immunocompromised patients (e.g., transplant recipients, hematologic malignancies, ICU patients), with a high morbidity and mortality. At the same time, the incidence of resistant pathogens (e.g., Candida auris, azole-resistant Aspergillus fumigatus) is increasing globally.

On the other hand, the antifungal armamentarium is also increasing, and a small number of antifungal drugs have had to be used compared to antibacterials; however, in recent years, new antifungal families and new action mechanisms are emerging. These new drugs are costly and must be used wisely.

The diagnosis of IFIs is sometime difficult to confirm, leading to both under-treatment (delays in starting therapy) and over-treatment (empirical or prophylactic use in patients without proven infection).

In this Special Issue, we are interested in reviewing the different approaches of antifungal stewardship programs, the main common problems in their implementation, and new insights into the topic.

Dr. Maricela Valerio Minero
Dr. Antonio Vena
Guest Editors

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