Anna Khanina1-3, David CM Kong4,6, Monica A Slavin1-3, Karin A Thursky1-5
1The National Centre for Infections in Cancer, Peter MacCallum Cancer Centre, 305 Grattan St, Melbourne, Victoria, 3000, Australia, 2Department of Infectious Diseases, Peter MacCallum Cancer Centre, 305 Grattan St, Melbourne, Victoria, 3000, Australia, 3Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Victoria, 3010, Australia, 4The National Centre for Antimicrobial Stewardship, Department of Infectious Diseases, University of Melbourne, The Peter Doherty Institute for Infection and Immunity, 792 Elizabeth St, Melbourne, Victoria, 3000, Australia, 5The Royal Melbourne Hospital Guidance Group, Royal Melbourne Hospital at the Peter Doherty Institute for Infection and Immunity, 792 Elizabeth St, Melbourne, Victoria, 3000, Australia, 6Centre for Medicine Use and Safety, Monash Institute of Pharmaceutical Sciences, Monash University, 381 Royal Parade, Parkville, Victoria, 3010, Australia
Abstract:
Invasive fungal infections (IFIs) pose significant risks to immunocompromised and critically ill patients, leading to considerable morbidity, mortality, and healthcare costs. The rise of multi-drug-resistant Candida auris and azole-resistant Aspergillus species intensifies this threat due to the limited antifungal options available. With an increasing number of patients with cancer and other immunocompromising conditions, there is a corresponding rise in the use of antifungals for both prevention and treatment of infection. However, studies reveal that 33-71% of antifungal prescriptions are inappropriate, heightening the risks of treatment failure, toxicity, drug-drug interactions, and the development of resistance. This underscores the urgent need for antifungal stewardship (AFS), which involves coordinated interventions to monitor and optimise antifungal use. National and international guidelines emphasize the importance of assessing antifungal prescribing quality employing data driven strategies to enhance quality improvement interventions. To address this, the Antifungal National Antimicrobial Prescribing Survey (Antifungal NAPS) offers an evidence based electronic audit tool designed to conduct comprehensive analyses of antifungal prescribing quality and patient outcomes. This tool aims to support healthcare facilities in optimising antifungal prescribing, invasive fungal infection management and ultimately, patient care.