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Evaluation of Antifungal Treatment Guidelines for Immunosuppressed Patients
Author(s) -
Chu KwokPui Jody,
Avent Minyon,
Shaw David R
Publication year - 2010
Publication title -
journal of pharmacy practice and research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.222
H-Index - 22
eISSN - 2055-2335
pISSN - 1445-937X
DOI - 10.1002/j.2055-2335.2010.tb00518.x
Subject(s) - medicine , caspofungin , voriconazole , posaconazole , micafungin , amphotericin b , intensive care medicine , antifungal , fluconazole , adverse effect , dermatology
Background The antifungal treatment guidelines for immunosuppressed patients at the Royal Adelaide Hospital were revised (based on a 2004 retrospective drug use evaluation) and implemented in June 2006. Aim To evaluate clinical practicality and compliance associated with the revised antifungal treatment guidelines for immunosuppressed patients. Method A prospective drug use evaluation was conducted at the hospital from January to December 2007. Patients admitted to the cancer service who received any of the following antifungals: conventional amphotericin, liposomal amphotericin, voriconazole, caspofungin and posaconazole, were reviewed prospectively according to established criteria. Results 53 patients who received 112 antifungal courses were evaluated. The majority of antifungals were used for empirical or possible fungal infections. The most common reason for changing antifungals during a treatment course was occurrence of toxicity or adverse effects. Compliance with the guidelines was approximately 70%; the majority of cases of non‐compliance were associated with liposomal amphotericin use. Conclusion The revised guidelines were well accepted and enabled early exclusion of patients who were at high risk of developing nephrotoxicity with conventional amphotericin.