Background and importance Invasive fungal infections are becoming frequent in hospitals and present a major mortality cause for transplanted patients. With the systemic emergence of these fungemia, caspofungin consumption is increasing greatly and consequently so are the pharmaceutical expenses in our establishment.
Aim and objectives To evaluate caspofungin prescriptions in the National Bone Marrow Transplant Centre (NBMTC), the indications, treatment duration and estimates of the treatment cost.
Material and methods A 5-month retrospective study from March to July 2021 in the paediatrics ward of 545 prescriptions for 19 patients where a data collection sheet was elaborated and validated for each new prescription. Data were processed afterwards and the results explored with Microsoft Excel Professional Plus 2016.
Results 95% of prescriptions adhere to the drug marketing authorisation (MA) approved indications (neutropenic fever, Candida and Aspergillus documented infections) and 5% use outside the MA, a mucormycosis. Average treatment duration was 25 days, with a 15-day average neutropenic fever and invasive candidiasis and a 63-day average for documented invasive aspergillosis. 32% of the treatment cost was attributed to post-transplant complications while 63% were costs for non-transplanted chemotherapy patients’ ‘complications’. In total the use of caspofungin cost €290 580, 51% of which were expenses to be paid by the National Health Insurance Fund and 49% to be paid in full by the NBMTC.
Conclusion and relevance With the high cost of caspofungin treatment and the type of patients treated at the NBMTC (immunosuppressed, transplanted, undergoing chemotherapy) a better optimisation of caspofungin use seemed inevitable and indispensable, starting by implying guidelines for a stricter control of the empirical treatment prescriptions and the regular follow-up of treatment durations and necessity of use of caspofungin.
Conflict of interest No conflict of interest
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