|Former: Atención Farmacéutica|
|Journal edited by Rasgo Editorial since 1983|
Manuela Velázquez Prieto
EDITOR IN CHIEF
Jaime E. Poquet Jornet
Tomás Casasín Edo
Virginia Hernández Corredoira
Ramón Jódar Masanés
Juan Carlos Juárez Giménez
Volume 20 - Issue 2, March-April 2018
DIRECTED ANTIFUNGAL TREATMENT IN PATIENTS WITH CANDIDEMIA: FACTORS THAT INFLUENCE DRUG SELECTION
ARÉVALO BERNABÉ ÁNGEL G, PUIG ASENSIO MIREIA, MARTÍN GÓMEZ Mª TERESA, LARROSA GARCÍA MARÍA, CAMPANY HERRERO DAVID
Introduction: Invasive candidiasis is a severe infection that frequently affects hospitalized patients. It can be caused by different strains of Candida spp, some of them are resistant to fluconazole and can be treated with echinocandins. Echinocandins are very useful for invasive candidiasis treatmentt however, they are not very efficient due to their high cost. The main objective of this study is to identify the variables determining the prescription of antifungal other than fluconazole when treating invasive candidiasis.
Method: Observational, retrospective unicentric study including patients diagnosed with invasive candidiasis during the years 2010 to 2014. Information about Candida spp. strain, antifungal sensitivity and antifungals prescribed has recorded.
Results: Out of 127 invasive candidiasis cases recorded, 52% were caused by C. albicans. 100% of C. albicans and C. parapsilosis strains and 87% of C. glabrata strains studied were sensitive to fluconazole. Fluconazole was the most commonly prescribed antifungal (72%), followed by echinocandins. Factors determining the prescription of an antifungal other than fluconazole were: positive blood culture of a strain not sensitive to fluconazole, recent fluconazole prophylactic treatment and identification of C. glabrata and C. krusei (p <0.05).
Discussion: The distribution of Candida spp species identified in this study is different from others reported in different times and locations. Fluconazole has the most prescribed drug for invasive candidiasis, which is the best choice in clinical, economical and epidemiological terms. Identification of variables affecting the antifungal
treatment choice promotes a better communication with the medical team and promotes the best treatment choice.
ANTIFUNGAL PRESCRIPTION – ECHINOCANDINS – FLUCONAZOLE – INVASIVE CANDIDIASIS