ArticleThe Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious Diseases
Evaluation of a stewardship program of antifungal use at a Brazilian tertiary care hospital.
Article in The Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious Diseases. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.
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Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Optimizing antifungal therapy: a systematic review of pharmacist interventions, stewardship approaches, and outcomes.Frontiers in medicine · 2024Pooled it
- Optimizing Antifungal Use Through Interdisciplinary Intervention in the Hematology Unit.Journal of fungi (Basel, Switzerland) · 2026Article
- Consensus for antifungal stewardship in China (2024 edition).Journal of thoracic disease · 2024Review
- Antifungal stewardship: the Latin American experience.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2023Review
- Study of Prescription-Indication of Outpatient Systemic Anti-Fungals in a Colombian Population. A Cross-Sectional Study.Antibiotics (Basel, Switzerland) · 2022Article
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Authors and funding
3 authors.
Funding
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Abstract
introductionStewardship programs have been developed to optimize the use of antibiotics, but programs focusing on antifungal agents are less frequent.
objectiveTo evaluate the quality of antifungal prescriptions in a tertiary care hospital, and to test if a simple educational activity could improve the quality of prescriptions.
methodsThe study comprised three phases: 1) Retrospective audit of all antifungal prescriptions in a 6-month period, applying a score based on six parameters: indication, drug, dosage, route of administration, microbiologic adequacy after results of cultures, switching to an oral agent, and duration of treatment; 2) Creation of text boxes in the electronic medical records with information about antifungal agents, shown during prescription; 3) Retrospective audit of all antifungal prescriptions in a 6-month period, applying the same 6-parameters score, and comparison between the two periods.
resultsAmong 333 prescriptions, fluconazole was the most frequently (80.5%) prescribed agent. Hematology (26.7%), Infectious Diseases Department (22.8%), Internal Medicine (15.9%) and Intensive Care Unit (14.4%) were the units with most antifungal prescriptions. The median score for the 333 prescriptions was 8.0 (range 0 - 10), and 72.7% of prescriptions were considered inappropriate. The median and mean scores in the first and second audit were 8.0 and 6.9, and 8.0 and 7.9, respectively (p<0.001). All items that comprised the score improved from the first to the second audit. Likewise, there was a reduction of inappropriate prescriptions (80.2% in the first audit vs. 64.6% in the second audit, p=0.001).
conclusionsA large proportion of inappropriate prescriptions was observed, which improved with the implementation of simple educational activities.
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