Abstract
BackgroundThe use of systemic antifungal agents has increased in most tertiary care centers. However, antifungal stewardship has deserved very little attention. Our objective was to assess the knowledge of European prescribing physicians as a first step of an international program of antifungal stewardship.MethodsStaff physicians and residents of 4 European countries were invited to complete a 20-point questionnaire that was based on current guidelines of invasive candidiasis and invasive aspergillosis.Results121 physicians (44.6% staff, 55.4% residents) from Spain 53.7%, Italy 17.4%, Denmark 16.5% and Germany 12.4% completed the survey. Hospital departments involved were: medical 51.2%, ICUs 43%, surgical 3.3% and pharmaceutical 2.5%. The mean score of adequate responses (± SD) was 5.8 ± 1.7 points, with statistically significant differences between study site and type of physicians. Regarding candidiasis, 69% of the physicians clearly distinguished colonization from infection and the local rate of fluconazole resistance was known by 24%. The accepted indications of antifungal prophylaxis were known by 38%. Regarding aspergillosis, 52% of responders could differentiate colonization from infection and 42% knew the diagnostic value of galactomannan. Radiological features of invasive aspergillosis were well recognized by 58% of physicians and 57% of them were aware of the antifungal considered as first line treatment. However, only 37% knew the recommended length of therapy.ConclusionsThis simple, easily completed questionnaire enabled us to identify some weakness in the knowledge of invasive fungal infection management among European physicians. This survey could serve as a guide to design a future tailored European training program.Electronic supplementary materialThe online version of this article (doi:10.1186/s12879-015-0809-z) contains supplementary material, which is available to authorized users.
Highlights
The use of systemic antifungal agents has increased in most tertiary care centers
Invasive fungal infections (IFIs), mainly invasive candidiasis (IC) and pulmonary aspergillosis (IPA), are a major clinical problem due to its high morbidity and mortality and affect many different patient populations cared by a large number of physicians in tertiary care hospitals
The difficulties for establishing a proven diagnosis, the better tolerance of new antifungal drugs and the demonstrated impact of early therapy have led to an extended use of empirical antifungal therapies (AF), mainly in critical and surgical patients
Summary
The use of systemic antifungal agents has increased in most tertiary care centers. Our objective was to assess the knowledge of European prescribing physicians as a first step of an international program of antifungal stewardship. Previous studies have shown that inappropriate use of antifungal drugs may reach 67-74% in tertiary care hospitals [2,3,4,5]. There are no multicenter studies evaluating the gaps in knowledge on diagnosis and treatment of IFIs and on compliance with current guidelines in European prescribing physicians. The aim of this study was to assess knowledge of potential AF prescribers in order to design and apply operative training strategies for European physicians, which will
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.
