Session Type: ePosters
Session Title: ePosters
Authors(s): E. Zavaleta (1), J.M. Chaverri (2), J.P. Diaz (1), B. Serrano (1), R. Escalona (2), A. Fallas (2), D. Trigueros (2)
Authors Affiliations(s): (1) Hospital Clinica Biblica, Costa Rica, (2) Universidad de Costa Rica, Costa Rica
Background:
There has been a significant increase in the incidence of systemic fungal infections, particularly those acquired within the hospital setting. To achieve a correct and rapid recovery in any patient who presents a severe fungal infection, a prompt and correct choice of antifungal therapy is essential. This study aims to collect the necessary information to help in the implementation of a hospital policy that allows the optimal use of systemic antifungal drugs.
Methods:A retrospective observational study of hospitalized patients from January to December 2018 was made. Patients 18 years and older, with complete medical records, a hospital stay longer than 48 hours and had received treatment with systemic antifungals in the hospital were included. To correlate the utilized systemic antifungal therapy with local resistance patterns and international treatment guidelines; drug prescription information, clinical data from each patient, and an antifungal-use score with a 1-10 scale was used. The gathered information was collected from the patient´s medical records, and the IBM SPSS® software was used for data processing.
Results:From 150 patients treated with systemic antifungal therapy, only 95 met the inclusion criteria. Candida albicans was the most frequently isolated species among the cultures, representing 50% of all fungal cultures. It was determined that 13% of the patients had a high risk of developing an invasive fungal infection, while 55% of them were classified as low risk. 92% of them had at least one microbiological culture, however, only 30 patients had specific cultures to determine the fungal species. Most of these patients were on antifungal therapy as prophylaxis for invasive candidiasis associated to their stay in the Intensive Care Unit, empirical therapy, or prescribed according to the results of cultures or clinical diagnosis. Most of the strategies (85%) obtained a moderately-acceptable therapy score (5-9); inappropriate duration, unnecessary prescription, inappropriate dosage among others were usually found.
Conclusions:In most cases it was determined that the management of systemic fungal infections was moderate-acceptable. The main factors associated with this were the lack of microbiological adjustments and the inadequate duration of therapy, both associated with the absence of fungal culture samples.
Keyword(s): systemic antifungals, fungal cultures, antimicrobial stewardshipSession Type: ePosters
Session Title: ePosters
Authors(s): E. Zavaleta (1), J.M. Chaverri (2), J.P. Diaz (1), B. Serrano (1), R. Escalona (2), A. Fallas (2), D. Trigueros (2)
Authors Affiliations(s): (1) Hospital Clinica Biblica, Costa Rica, (2) Universidad de Costa Rica, Costa Rica
Background:
There has been a significant increase in the incidence of systemic fungal infections, particularly those acquired within the hospital setting. To achieve a correct and rapid recovery in any patient who presents a severe fungal infection, a prompt and correct choice of antifungal therapy is essential. This study aims to collect the necessary information to help in the implementation of a hospital policy that allows the optimal use of systemic antifungal drugs.
Methods:A retrospective observational study of hospitalized patients from January to December 2018 was made. Patients 18 years and older, with complete medical records, a hospital stay longer than 48 hours and had received treatment with systemic antifungals in the hospital were included. To correlate the utilized systemic antifungal therapy with local resistance patterns and international treatment guidelines; drug prescription information, clinical data from each patient, and an antifungal-use score with a 1-10 scale was used. The gathered information was collected from the patient´s medical records, and the IBM SPSS® software was used for data processing.
Results:From 150 patients treated with systemic antifungal therapy, only 95 met the inclusion criteria. Candida albicans was the most frequently isolated species among the cultures, representing 50% of all fungal cultures. It was determined that 13% of the patients had a high risk of developing an invasive fungal infection, while 55% of them were classified as low risk. 92% of them had at least one microbiological culture, however, only 30 patients had specific cultures to determine the fungal species. Most of these patients were on antifungal therapy as prophylaxis for invasive candidiasis associated to their stay in the Intensive Care Unit, empirical therapy, or prescribed according to the results of cultures or clinical diagnosis. Most of the strategies (85%) obtained a moderately-acceptable therapy score (5-9); inappropriate duration, unnecessary prescription, inappropriate dosage among others were usually found.
Conclusions:In most cases it was determined that the management of systemic fungal infections was moderate-acceptable. The main factors associated with this were the lack of microbiological adjustments and the inadequate duration of therapy, both associated with the absence of fungal culture samples.
Keyword(s): systemic antifungals, fungal cultures, antimicrobial stewardship