Impact of an antifungal stewardship programme in a teaching hospital: a prospective study

Ref ID: 17763

Author:

V. Mondain, F. Lieutier, M. Gari-Toussaint, L. Hasseine, C. Lions,
C. Pulcini*

Author address:

Nice, Marseille, FR)

Full conference title:

22nd European Congress of Clinical Microbiology and Infectious Diseases

Abstract:

Objectives: A multifaceted antifungal stewardship program has been
in place in our teaching tertiary-care hospital since 2005, with several
actions implemented successively, including systematic evaluation of
all costly antifungal prescriptions (echinocandins, lipid formulations of
amphotericin B, posaconazole and voriconazole). We assessed the
impact of this program on antifungal prescriptions and cost (between
2003 and 2010), and on standards of care regarding the management of
invasive aspergillosis and candidemia .
Methods: We conducted a prospective observational study over an 8-
year period.
Results: Six hundred and thirty-six antifungal prescriptions were
discussed by the antifungal management team from 2005 to 2010,
mainly from the haematology department (72%). In 344/636 (54%)
cases, a piece of advice was fed back in real time to the physician in
charge of the patient, with an 88% compliance rate. Optimal standard
of care was achieved for performance of chest CT-scan,
galactomannan antigen testing and voriconazole therapeutic drug
monitoring for invasive aspergillosis, with no antifungal combination
therapies used since 2008. Regarding candidemia, optimal standard of
care was achieved for timing of antifungal therapy, recommended 1stline
therapy, duration of therapy and removal of central venous
catheters. Antifungal prescriptions and cost were stable between 2003
and 2010.
Conclusion: Implementation of an antifungal stewardship program
was feasible, sustainable and well-accepted, and we observed an
improved quality of care and no increase in antifungal use or cost.

Abstract Number: P850

Conference Poster: y

Conference Year: 2012

Link to conference website: NULL

New link: NULL

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