Abstract
The appropriate use of antimicrobial agents improves clinical outcomes and reduces antimicrobial resistance. Nevertheless, data on inappropriate prescription and negative outcomes are inconsistent. The objective of this study was to assess the prescription appropriateness of Caspofungin at a tertiary teaching hospital in Saudi Arabia and the impact on mortality at 30 days. A retrospective chart review was performed for patients who received Caspofungin from May 2015 to December 2019 to obtain prescription information and culture and susceptibility tests. The appropriateness of the dosage (ApD), initiation time (ApI), agent selection (ApS), and duration of therapy (ApDUR) was evaluated based on recommendations of the infectious diseases society of America. 355 eligible patients who received 3458 Caspofungin doses were identified. Their median age was 54 years (range 18–96). Overall, 270 (76.1%) patients received empirical prescriptions, of which 74.4% had the appropriate dose, and 56.3% had received it for more than five days, despite no proven Candida infection. This was not influenced by past medical history (p = 0.394). Only 39% of patients who received definitive prescriptions met all four study criteria for appropriate prescription. Therefore, antimicrobial stewardship programs can improve the appropriate utilization of antifungal therapies.
Highlights
Invasive fungal infections (IFIs) result in high morbidity and mortality [1]
The patients were divided into two groups, the empiric therapy (ET) group (n = 270, 76.1%) and the definitive therapy (DT) group (n = 85, 23.9%)
Some physicians justify the need for empirical antifungal therapy by calculating the Candida score established by Leon et al [19]
Summary
Invasive fungal infections (IFIs) result in high morbidity and mortality [1]. In tertiary care hospitals, healthcare-associated bloodstream infections are most commonly caused by Candida [2]. Non-albicans Candida species, which frequently show resistance to fluconazole, are increasingly recognized as the cause of invasive fungal infections [4] In 2014, Omrani et al from Saudi Arabia reported invasive bloodstream. States Food and Drug Administration (US-FDA) for candidemia, esophageal candidiasis, and invasive Candida infections (ICI) that are refractory or intolerant to other agents. It is prescribed as empiric therapy when invasive fungal infection is suspected. The dose adjustment is 35 mg in patients with moderate hepatic impairment with a Child-Pugh score of ≥7 points Adherence to this recommendation is unknown [7]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
