Introduction of an antifungal stewardship programme targeting high-cost antifungals at a tertiary hospital in Cambridge, England

被引:76
作者
Micallef, C. [1 ]
Aliyu, S. H. [2 ]
Santos, R. [1 ]
Brown, N. M. [2 ]
Rosembert, D. [1 ]
Enoch, D. A. [2 ]
机构
[1] Cambridge Univ Hosp NHS Fdn Trust, Addenbrookes Hosp, Dept Pharm, Cambridge CB2 0QQ, England
[2] Publ Hlth England, Clin Microbiol & Publ Hlth Lab, Cambridge CB2 0QW, England
关键词
voriconazole; liposomal amphotericin B; caspofungin; micafungin;
D O I
10.1093/jac/dkv040
中图分类号
R51 [传染病];
学科分类号
100401 ;
摘要
Background: Antifungal stewardship aims to promote the optimal use of antifungals through the careful selection of agents based on patient profile, target organism, toxicity, costs and the likelihood of emergence and spread of resistance. Methods: We report on an observational prospective 12 month study conducted by an antifungal stewardship team targeting the use of echinocandins (caspofungin and micafungin), voriconazole and liposomal amphotericin B in a tertiary referral hospital in the UK. Results: One-hundred-and-seventy-three patients were reviewed on 294 occasions. Clinical advice was given and implemented during review of 45 (88.2%) of micafungin prescriptions, 70 (78.7%) of those receiving voriconazole, 78 (62.4%) of those receiving liposomal amphotericin B and 3 (27.3%) of those receiving caspofungin. Except for voriconazole, nearly half of all treatments reviewed were stopped or changed. This study found that a crude cost saving of similar to 180000 pound in antifungal drugs was generated compared with the previous year. Conclusions: Using a multidisciplinary team, antifungal stewardship can achieve significant improvements in patient management and it may reduce costs.
引用
收藏
页码:1908 / 1911
页数:4
相关论文
共 7 条
  • [1] Impact of Education and an Antifungal Stewardship Program for Candidiasis at a Thai Tertiary Care Center
    Apisarnthanarak, Anucha
    Yatrasert, Apiwat
    Mundy, Linda M.
    [J]. INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY, 2010, 31 (07) : 722 - 727
  • [2] Revised definitions of invasive fungal disease from the European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) Consensus Group
    De Pauw, Ben
    Walsh, Thomas J.
    Donnelly, J. Peter
    Stevens, David A.
    Edwards, John E.
    Calandra, Thierry
    Pappas, Peter G.
    Maertens, Johan
    Lortholary, Olivier
    Kauffman, Carol A.
    Denning, David W.
    Patterson, Thomas F.
    Maschmeyer, Georg
    Bille, Jacques
    Dismukes, William E.
    Herbrecht, Raoul
    Hope, William W.
    Kibbler, Christopher C.
    Kullberg, Bart Jan
    Marr, Kieren A.
    Munoz, Patricia
    Odds, Frank C.
    Perfect, John R.
    Restrepo, Angela
    Ruhnke, Markus
    Segal, Brahm H.
    Sobel, Jack D.
    Sorrell, Tania C.
    Viscoli, Claudio
    Wingard, John R.
    Zaoutis, Theoklis
    Bennett, John E.
    [J]. CLINICAL INFECTIOUS DISEASES, 2008, 46 (12) : 1813 - 1821
  • [3] A non-compulsory stewardship programme for the management of antifungals in a university-affiliated hospital
    Lopez-Medrano, F.
    San Juan, R.
    Lizasoain, M.
    Catalan, M.
    Ferrari, J. M.
    Chaves, F.
    Lumbreras, C.
    Montejo, J. C.
    Herreros de Tejada, A.
    Aguado, J. M.
    [J]. CLINICAL MICROBIOLOGY AND INFECTION, 2013, 19 (01) : 56 - 61
  • [4] A 6-year antifungal stewardship programme in a teaching hospital
    Mondain, V.
    Lieutier, F.
    Hasseine, L.
    Gari-Toussaint, M.
    Poiree, M.
    Lions, C.
    Pulcini, C.
    [J]. INFECTION, 2013, 41 (03) : 621 - 628
  • [5] Antimicrobial Stewardship at a Large Tertiary Care Academic Medical Center: Cost Analysis Before, During, and After a 7-Year Program
    Standiford, Harold C.
    Chan, Shannon
    Tripoli, Megan
    Weekes, Elizabeth
    Forrest, Graeme N.
    [J]. INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY, 2012, 33 (04) : 338 - 345
  • [6] Evaluation of antifungal use in a tertiary care institution: antifungal stewardship urgently needed
    Valerio, Maricela
    Guadalupe Rodriguez-Gonzalez, Carmen
    Munoz, Patricia
    Caliz, Betsabe
    Sanjurjo, Maria
    Bouza, Emilio
    [J]. JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY, 2014, 69 (07) : 1993 - 1999
  • [7] Zarb P, 2012, EURO SURVEILL, V17