Background Antifungal treatment is an important part of global expenditure. A significant increase in the use of these drugs does entail a higher cost.
It is hoped that the use of these drugs will continue to increase each year. It is important to know the drug use distribution through the different units and the monetary cost in order to put forward pharmacist interventions.
Purpose To describe the evolution of expenditure on, and consumption of, caspofungin, voriconazole, amphotericin B and fluconazole and significant fungaemia from 2009 to 2011.
Materials and Methods Observational, retrospective study, carried out in a General Hospital.
The consumption for every single patient of caspofungin, voriconazole, liposomal amphotericin B and fluconazole, from 2009 to 2011, were obtained from the Pharmacy Department Software databases (Langtools). Average prices were used to calculate the financial impact. In the microbiology department, blood cultures were done for every patient treated with these drugs for fungal isolates.
Results Pharmaceutical spending on these four drugs versus general expenditure was 1.53%, 1.04% and 1.00% for the years 2009, 2010 and 2011 respectively. The evolution of consumption in units (including all presentations) and expenditure is shown in the following table (table 1).
The total consumption of the main services in the study period is shown in the following table (table 2).
The number of yeasts isolated from blood cultures was 20, 19 and 21 for the years 2009, 2010 and 2011 respectively, representing 2.48% of all positive blood cultures.
Conclusions Antifungal spending is disproportionately high considering the low number of fungal isolates, and entails a high use of empirical and prophylactic treatment.
Haematology is, by far, the main department responsible for the use of antifungal treatment. Consumption of voriconazole and liposomal amphotericin B are increasing, meanwhile caspofungin is decreasing in recent years.
No conflict of interest.
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