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4CPS-058 Analysis of antifungal consumption in an intensive care unit over 5 years
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  1. I Patier1,
  2. M Achaques-Rodriguez2,
  3. FJ Alonso-Zazo3,
  4. F Fernandez-Fraga4
  1. 1Hospital Universitario de San Jorge, Pharmacy, Huesca, Spain
  2. 2Universitario Quironsalud Madrid, Pharmacy, Pozuelo de Alarcon, Spain
  3. 3Hospital Clínico San Carlos, Pharmacy, Madrid, Spain
  4. 4Hospital Universitario de Mostoles, Pharmacy, Mostoles, Spain

Abstract

Background and Importance Fungal infections pose a high cost, both in terms of morbidity and mortality, as well as economically. Antifungal treatments (AF) generally receive less attention and review in Antimicrobial Stewardship Programs (ASP) than antimicrobials. These infections have increased in recent years, primarily due to the rising number of patients with risk factors for invasive fungal infection, such as immunosuppressed patients and those who have received broad-spectrum antibiotic treatments.

Aim and Objectives To analyse the consumption of broad-spectrum antifungals in the Intensive Care Unit (ICU) of our centre over a 5-year period, observe trends, and assess whether the SARS-CoV-2 pandemic has altered their usage.

Material and Methods This is a comparative, retrospective, longitudinal study of the consumption of systemic broad-spectrum antifungals (liposomal amphotericin B, voriconazole, caspofungin, anidulafungin and micafungin) in the ICU of a third-level University Hospital in Spain. DDD and DOT/100 Bed Days were calculated for each AF. Data on treatment duration and the number of episodes with prescribed antifungals were obtained.

Results Over the 5-year study period, a total of 855 admissions were included, generating a cumulative stay of 10,686 days, with AF prescribed in 12 episodes/100 admissions. A consistent distribution pattern was observed, with liposomal amphotericin B (LBL) being the primary prescribed AF (close to 50%), followed by echinocandins (30%), and finally voriconazole (25.3%). The median overall consumption was 39.26 DDD/100B (39.21–65.12) and 9.03 DOT/100B (8.34–10.46). This represented a 42.9% decrease in DDD/100B and a 42.5% decrease in DOT/100B, primarily due to reduced LBL usage, which decreased by 54.3%. Regarding the average duration of each AF cycle, there was a decreasing trend from 12.65 to 9.4 days.

Conclusion and Relevance The consumption of AF in our centre’s ICU has significantly decreased during the study period, coupled with a reduction in the average treatment duration. Concerning the most acute phase of the COVID-19 pandemic (2020), there is an increase in AF consumption related to an increase in the number of episodes with AF and overall ICU activity, which decreases in 2021 and 2022.

Conflict of Interest No conflict of interest.

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