Antifungal consumption trends in the adult intensive care unit of a university hospital in Bahia, Brazil

Abstract

Systemic fungal infections represent an emerging problem in current clinical practice, requiring studies on the use of antifungals (ATF). This study aims to analyze ATF consumption trends in an Intensive Care Unit (ICU) for adults at a University Hospital (UH) in Bahia, Brazil. Descriptive and retrospective study, based on consumption records of systemic ATF standardized DDD)/100 patient-days (PD) was proposed. Oscillations in global consumption were observed with a total average of 33.30 DDD/100 PD. There was a reduction in the number of PD treated in the ICU in the first years of the study (2009-2014), followed by an increase of 89.25% between 2014 and 2016, remaining constant in the period from 2016 to 2020. The most consumed ATF, in descending order, were: Fluconazole (57.92%), Amphotericin B Lipid Complex (12.19%), Liposomal Amphotericin B (7.83%), Caspofungin (6.30%) and Amphotericin B Deoxycholate (6.03%). The general variation in drug consumption was 38%, with an increasing trend (p=0.45). Echinocandins showed a growth variation of 591% during the period of this study. Micafungin showed an increasing consumption trend and varied by 98.69% (p=0.001), while caspofungin showed a reduction of 47.77% (p=0.027). The growing trends in ATF consumption in this unit demonstrate the need for monitoring and promoting the rational use of these drugs. Inadequate and/or excessive use, in addition to burdening the healthcare system by increasing costs, can increase the resistance of fungi to the only agents available to combat fungal infections.