氟康唑
药方
三级护理
抗真菌
伏立康唑
两性霉素B
抗真菌药
管理(神学)
医学
卡斯波芬金
重症监护医学
抗菌管理
内科学
药理学
抗生素
微生物学
抗生素耐药性
生物
法学
政治
政治学
皮肤病科
作者
Harsimran Kaur,Sivanantham Krishnamoorthi,Navneet Dhaliwal,Manisha Biswal,Shreya Singh,Valliappan Muthu,Shivaprakash M. Rudramurthy,Ritesh Agarwal,Sushmita Ghoshal,Surjit Singh,Pankaj Malhotra,Sanjay Jain,Ram Samujh,Anup Ghosh,Arunaloke Chakrabarti
出处
期刊:Mycoses
[Wiley]
日期:2022-08-16
卷期号:65 (10): 935-945
被引量:2
摘要
Antifungal stewardship is a less explored component of antimicrobial stewardship programmes, especially in developing countries.We aimed to determine antifungal prescription practices in a tertiary centre of a developing country to identify the challenges for antifungal stewardship programmes.Four single-day point prevalent surveys were performed in inpatient units and data were collected from medical records. Antifungal use was recorded in terms of consumption, therapeutic strategies and appropriateness.We found a 2.42%-point prevalence of antifungal prescriptions. Antifungal use was higher in children than adults (4.1% vs. 2.03%), medical than surgical units (3.7% vs. 1.24%) and ICUs than general wards (5.8% vs. 1.9%). The highest antifungal use was observed in the haematology-oncology units (29.3%) followed by emergency (16.2%) and gastroenterology units (11.6%). Among 215 prescriptions, amphotericin B was the most commonly prescribed (50.2%) followed by fluconazole (31.6%). The targeted antifungal therapy was practised more commonly (31.5%) than empiric (29.1%), pre-emptive (22.6%) and prophylactic (16.8%) therapy. Amphotericin B was commonly used for pre-emptive (p = .001) and targeted (p = .049) therapy, while fluconazole (p = .001) and voriconazole (p = .011) for prophylaxis. The prescriptions were inappropriate in 25.1% due to the wrong choice of antifungal (44.4%), indication (27.7%) and dosage (24%). The overall mean antifungal consumption was 2.71 DDD/1000 PD and 8.96 DOT/1000 PD.We report here the low prevalence of antifungal use at a tertiary care centre in a developing country. Though training for antifungal use would be important for antifungal stewardship, the challenge would remain with the affordability of antifungals.
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