Support for fungal infection treatment mediated by pharmacist-led antifungal stewardship activities

Masaru Samura, Naoki Hirose, Takenori Kurata, Junichi Ishii, Fumio Nagumo, Keisuke Takada, Sakura Koshioka, Masaki Uchida, Syunya Yamamoto, Junki Inoue, Yuki Enoki, Kazuaki Taguchi, Akira Ishida, Hisakazu Sekine, Norifumi Kunika, Hiroyuki Kunishima, Kazuaki Matsumoto

Research output: Contribution to journalArticle

Abstract

Objective: At the Yokohama General Hospital, pharmacist-led antimicrobial stewardship programs (ASP) including antifungal stewardship programs (AFP) were started in 2012. To investigate the efficacy of the programs, we compared several parameters that are recommended for the measurement of ASP in Japan based on pre- and post-AFP activities. Patients and methods: The subjects were inpatients who developed candidemia between April 2008 and March 2016. They were divided into two groups: pre-AFP (April 2008 until March 2012) and post-AFP (April 2012 until March 2016). The results were compared between the two groups. Results: The cumulative optimal antifungal drug usage rate, as a process parameter, significantly increased in the post-AFP group (p = 0.025). Furthermore, the days of therapy of antifungal drugs in the pre- and post-AFP groups was median 6.0 (interquartile range [IQR] 0.3–15.7) and median 3.4 (IQR 1.9–3.4) per 1,000 patient-days, respectively; there was a significant decrease in the post-AFP group (p < 0.001). Expenditure on antifungal drugs, as an outcome parameter, in the pre- and post-AFP groups was 9390.5 ± 5687.1 and 5930.8 ± 4687.0 US dollars, respectively; there was a significant decrease in the post-AFP group (p = 0.002). Conclusions: These results suggest that pharmacist-led antifungal stewardship activities improve both outcome and process parameters.

Original languageEnglish
JournalJournal of Infection and Chemotherapy
DOIs
Publication statusAccepted/In press - 2019 Jan 1

Keywords

  • Antifungal drugs
  • Antifungal stewardship
  • Candidemia
  • Optimal use

ASJC Scopus subject areas

  • Microbiology (medical)
  • Pharmacology (medical)
  • Infectious Diseases

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    Samura, M., Hirose, N., Kurata, T., Ishii, J., Nagumo, F., Takada, K., Koshioka, S., Uchida, M., Yamamoto, S., Inoue, J., Enoki, Y., Taguchi, K., Ishida, A., Sekine, H., Kunika, N., Kunishima, H., & Matsumoto, K. (Accepted/In press). Support for fungal infection treatment mediated by pharmacist-led antifungal stewardship activities. Journal of Infection and Chemotherapy. https://doi.org/10.1016/j.jiac.2019.09.016