Online citations, reference lists, and bibliographies.
← Back to Search

Antifungal Use In Intensive Care Units.

E. Meyer, F. Schwab, P. Gastmeier, H. Ruden, A. Heininger
Published 2007 · Medicine

Save to my Library
Download PDF
Analyze on Scholarcy
Share
OBJECTIVES To provide benchmarking data on antifungal use in intensive care units (ICUs), to analyse risk factors and to look for correlations with antibiotic use data and structure parameters. METHODS Antimicrobial use data for 13 ICUs were obtained from computerized databases from January 2004 through June 2005. Antimicrobial usage density (AD) is expressed as daily defined doses/1000 patient-days. Correlations were calculated by the Spearman correlation or for binomic variables by the two-sided Wilcoxon test. A multivariate regression analysis was performed to identify independent risk factors for the outcome 'antifungal use'. RESULTS Mean systemic antifungal drug use was 93.0, the range being between ADs of 18.9 and 232.2. ICUs treating transplant patients had a significantly higher mean antifungal usage at 152.9 compared with ICUs not treating transplant patients where the AD was 46.0. Fluconazole was the most frequently prescribed antifungal (mean AD 69.6) followed by amphotericin B (11.4) and voriconazole (6.2). Antifungal use correlated significantly with the consumption of quinolones, carbapenems and extended-spectrum penicillins, but not with total antibiotic use and not with the type of ICU or university status. In the multivariate linear regression analysis, two parameters, i.e. high quinolone use (P = 0.002) and ICUs which treat transplant patients (P = 0.027), were independent risk factors for a high level of antifungal use. CONCLUSIONS Antifungal use was heterogeneous in German ICUs with the mean AD lying at 93. Benchmarking data might provide a useful method for assessing strategies that aim to reduce antifungal use in ICUs. However, data should be stratified for ICUs with and without transplant patients.
This paper references
10.1016/J.AJIC.2003.09.002
National Nosocomial Infections Surveillance (NNIS) System Report, data summary from January 1992 through June 2003, issued August 2003.
Nnis System (2003)
10.1097/01.CCM.0000202208.37364.7D
A bedside scoring system (“Candida score”) for early antifungal treatment in nonneutropenic critically ill patients with Candida colonization*
C. León (2006)
10.1097/01.CCM.0000201897.78123.44
Invasive candidiasis in the intensive care unit
L. Ostrosky-Zeichner (2006)
10.1053/JHIN.2002.1354
Correlation between candiduria and departmental antibiotic use.
M. Weinberger (2003)
10.1186/1472-6904-5-1
Hospital use of systemic antifungal drugs
K. de With (2005)
10.1097/01.CCM.0000231883.93001.E0
Surgical critical care: Fungal infections in surgical patients
P. Lipsett (2006)
Antifungal use
10.1016/0002-9343(91)90367-7
Nosocomial infection rates in adult and pediatric intensive care units in the United States. National Nosocomial Infections Surveillance System.
W. Jarvis (1991)
Research Programme. DANMAP 2004—Use of Antimicrobial Agents and Occurrence of Antimicrobial Resistance in Bacteria from Food Animals, Foods and Humans in Denmark
(2007)
10.1093/JAC/DKH163
Reduction in broad-spectrum antimicrobial use associated with no improvement in hospital antibiogram.
P. Cook (2004)
10.1007/s00134-004-2266-9
Surveillance of antimicrobial use and antimicrobial resistance in intensive care units (SARI): 1. Antimicrobial use in German intensive care units
E. Meyer (2004)
10.1093/JAC/48.2.303
Use of fluconazole in daily practice: still room for improvement.
S. Natsch (2001)
10.1016/S1473-3099(04)01145-4
How antibiotics can make us sick: the less obvious adverse effects of antimicrobial chemotherapy.
S. Dancer (2004)
10.1097/01.IDC.0000144912.27311.19
Nosocomial bloodstream infections in US hospitals: Analysis of 24,179 cases from a prospective nationwide surveillance study
J. Bartlett (2004)
10.1086/421946
Nosocomial bloodstream infections in US hospitals: analysis of 24,179 cases from a prospective nationwide surveillance study.
H. Wisplinghoff (2004)
10.1007/s15010-003-3201-7
Design of a Surveillance System of Antibiotic Use and Bacterial Resistance in German Intensive Care Units (SARI)
E. Meyer (2003)
10.1111/J.1365-2125.2004.02164.X
European surveillance of antimicrobial consumption (ESAC): data collection performance and methodological approach.
R. Vander Stichele (2004)



This paper is referenced by
10.1097/QCO.0b013e32834e0680
The case for antifungal stewardship
M. Ananda-Rajah (2012)
10.1007/s10096-011-1315-x
Use of antifungal agents in pediatric and adult high-risk areas
E. Ramírez (2011)
10.1111/j.1439-0507.2009.01838.x
Leitliniengerechte Therapie: Candidämie/invasive Candidiasis
A. Glöckner (2010)
Эмпирическая терапия инвазивного кандидоза в отделениях реанимации и интенсивной терапии: современное состояние проблемы
A. Veselov (2011)
10.1111/j.1469-0691.2012.03784.x
Anidulafungin for the treatment of candidaemia/invasive candidiasis in selected critically ill patients
M. Ruhnke (2012)
10.1515/intox-2016-0014
Study of the cytotoxic/toxic potential of the novel anticancer selenodiazoloquinolone on fibroblast cells and 3D skin model
S. Jantová (2016)
10.1016/J.EIMC.2012.02.006
Evolución del consumo de antifúngicos en pacientes críticos. Estudio multicéntrico observacional, 2006-2010
P. Olaechea-Astigarraga (2012)
10.2165/10898550-000000000-00000
Management of Invasive Candidiasis in the Intensive Care Unit
E. Playford (2012)
10.12677/JOCR.2017.54022
Advances in the Study of Microwave Irradiation Efficient Construction of Heterocyclic Compounds with Enaminone or Enamino Ester as Building Blocks
白 海瑞 (2017)
10.1177/0885066609355262
Invasive Fungal Infections in the ICU
S. Shoham (2010)
10.1111/j.1439-0507.2008.01645.x
Treatment of invasive candidiasis with echinocandins
A. Glöckner (2009)
10.1016/j.micpath.2017.12.069
Candida infanticola and Candida spencermartinsiae yeasts: Possible emerging species in cancer patients.
T. Shokohi (2018)
10.1016/j.micpath.2010.04.002
Role of amphotericin B upon enhancement of protective immunity elicited by oral administration with liposome-encapsulated-Japanese encephalitis virus nonstructural protein 1 (NS1) in mice.
T. Lin (2010)
10.1111/jam.14949
BIOFILM OF Candida albicans: FORMATION, REGULATION AND RESISTANCE.
Rafael Pereira (2020)
10.1016/j.jphotobiol.2010.09.007
Photochemical and phototoxic properties of ethyl 1,4-dihydro-8-nitro-4-oxoquinoline-3-carboxylate, a new quinoline derivative.
S. Jantová (2011)
10.1007/s00063-008-1058-3
Echinocandine bei invasiven Candida-Infektionen
A. Glöckner (2008)
Re-imagining the surveillance of invasive mould diseases
M. Ananda-Rajah (2014)
10.1111/j.1469-0691.2012.03973.x
Antifungal therapy in European hospitals: data from the ESAC point-prevalence surveys 2008 and 2009.
P. Zarb (2012)
10.1111/myc.12912
Systemic antifungal drug use in Belgium—One of the biggest antifungal consumers in Europe
Berdieke Goemaere (2019)
10.1080/08820139.2017.1280050
Assessment of Immunomodulatory Activities and in vitro Toxicity of New Quinolone 7-ethyl 9-ethyl-6-oxo-6,9-dihydro[1,2,5]selenadiazolo[3,4-h]quinoline-7-carboxylate
S. Jantová (2017)
10.1007/978-1-4939-9034-4_59
Antimicrobial Stewardship: Considerations for a Transplant Center
S. Seo (2019)
10.1016/j.tiv.2016.02.012
Pro-apoptotic effect of new quinolone 7- ethyl 9-ethyl-6-oxo-6,9-dihydro[1,2,5]selenadiazolo [3,4-h]quinoline-7-carboxylate on cervical cancer cell line HeLa alone/with UVA irradiation.
S. Jantová (2016)
10.3390/microorganisms8020154
Candida albicans Antifungal Resistance and Tolerance in Bloodstream Infections: The Triad Yeast-Host-Antifungal
S. Costa-de-Oliveira (2020)
10.21037/jtd.2016.12.97
Antifungal use in intensive care units: another uncertainty that highlights the need for precision medicine.
R. Moghnieh (2016)
10.1097/ACO.0b013e32833a254d
Azole antimycotics and drug interactions in the perioperative period
T. Saari (2010)
10.2146/ajhp100423
Antifungal use in hospitalized adults in U.S. academic health centers.
A. Pakyz (2011)
10.1586/14787210.2016.1096776
Consumption of systemic antifungal agents among acute care hospitals in Catalonia (Spain), 2008–2013
E. Fondevilla (2016)
10.1097/QCO.0b013e3283177967
Antifungals in the ICU
E. Playford (2008)
10.1080/21505594.2016.1226721
Antifungal stewardship considerations for adults and pediatrics
R. Hamdy (2017)
10.1039/C6RA28631C
Efficient synthesis of novel N-substituted 2-carboxy-4-quinolones via lithium bis(trimethylsilyl)amide (LiHMDS)-induced in situ cyclocondensation reaction
Phool Hasan (2017)
Semantic Scholar Logo Some data provided by SemanticScholar