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[Trends in systemic antifungal use in critically ill patients. Multicenter observational study, 2006-2010].
- Source :
-
Enfermedades infecciosas y microbiologia clinica [Enferm Infecc Microbiol Clin] 2012 Oct; Vol. 30 (8), pp. 435-40. Date of Electronic Publication: 2012 Mar 29. - Publication Year :
- 2012
-
Abstract
- Introduction: There are limited data about the use of antifungal agents (AF) in critically ill patients and treatment trends since the inclusion of the new generation AF. The use of these agents may have a significant influence on the development of new resistances.<br />Methods: Observational prospective study of the systemic use of AF in patients admitted to Spanish intensive care units (ICU) participating in the ENVIN-HELICS register, from 2006 to 2010. The annual use, the indications that led to that use and, the intra-ICU infections, the AF employment related to the hospital size, and per 1000 patients/day, were compared.<br />Results: Of the 8240 prescriptions for AF, fluconazole and caspofungin were the most often employed (55% and 19.5%, respectively). An increase in use was observed to the year 2008, with subsequent stabilisation. A decrease in the use of fluconazole and an increase in echinocandins consumption was observed over time. As regards the intra-ICU infections, the AF were ordered empirically in 47.9% of the indications. Fluconazole was more frequently used in medium size hospitals than in the large ones (60.4% versus 53.3%; P=.036) and the opposite occurred in the case of caspofungin (15.8% versus 21.8%; P<.001). Fluconazole was more prematurely employed (median 12 days since ICU admission) and the duration of the therapy was similar to the other AF (median 8 days). The total therapy days were 39.51 per 1000 patient/day, with predominance in fluconazole use (21.48 per 1000 patients/day).<br />Conclusions: Fluconazole is the most used antifungal agent in critically ill patients in any of the indications, although a progressive decrease in its use is observed, with a proportional increase in the use of echinocandins.<br /> (Copyright © 2011 Elsevier España, S.L. All rights reserved.)
- Subjects :
- Amphotericin B therapeutic use
Antifungal Agents administration & dosage
Caspofungin
Community-Acquired Infections drug therapy
Community-Acquired Infections epidemiology
Cross Infection drug therapy
Cross Infection epidemiology
Drug Prescriptions statistics & numerical data
Drug Utilization statistics & numerical data
Drug Utilization trends
Echinocandins therapeutic use
Female
Fluconazole therapeutic use
Hospital Bed Capacity
Humans
Immunocompromised Host
Intensive Care Units statistics & numerical data
Lipopeptides
Male
Middle Aged
Mycoses drug therapy
Mycoses epidemiology
Mycoses prevention & control
Neutropenia complications
Prospective Studies
Registries
Spain epidemiology
Antifungal Agents therapeutic use
Critical Illness
Subjects
Details
- Language :
- Spanish; Castilian
- ISSN :
- 1578-1852
- Volume :
- 30
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Enfermedades infecciosas y microbiologia clinica
- Publication Type :
- Academic Journal
- Accession number :
- 22463989
- Full Text :
- https://doi.org/10.1016/j.eimc.2012.02.006