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<p>Misuse and overuse of antimicrobials, such as fungal agents, is a factor in the
development of drug-resistant pathogens. NHS England’s national pharmacy and prescribing
clinical lead is supported by seven regional antimicrobial stewardship (AMS) leads.
These AMS leads collaborate with regional National Health Service stakeholders and
partner organisations, including infection prevention and control, patient safety,
diagnostics and sepsis teams, the Department, the UK Health Security Agency (UKHSA),
Health Education England and the Care Quality Commission, to contribute to multi-professional
endeavours to mitigate the threat of antimicrobial resistance (AMR).</p><p>NHS England’s
AMR diagnostics team advise that high-level research has been undertaken to understand
the need for optimal fungal diagnostics and resistance testing. This has highlighted
opportunities for improvement in data collection regarding the use of diagnostics,
surveillance and consistent access to diagnostics.</p><p>The UKHSA reports on antifungal
resistance against systemic antifungals utilised in the treatment of candidaemia,
in the English Surveillance Programme for Antimicrobial Utilisation and Resistance
report. Resistance to the key antifungals, amphotericin B, caspofungin and fluconazole,
appears to have been decreasing in all Candida species. Fluconazole resistance decreased
from 8.2% of Candida blood isolates tested in 2016 to 3.2% in 2020. Resistance to
amphotericin B and caspofungin decreased slightly from 2016 to 2020, by 1.3% to 1.1%,
and 3.4% to 3.3% respectively.</p>
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