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Hospital use of systemic antifungal drugs: a multi-center surveillance update from Germany
Barbara N Gross1, Michaela Steib-Bauert, Winfried V Kern
1Pharmacy, University Medical Center Freiburg, Freiburg, Germany, barbara.gross@uniklinik-freiburg.de.
Background:
The consumption of antifungal agents increased over the last decade, resulting in the development of resistant organisms and causing a significant pharmaco economic burden. Antifungal drugs are widely used for the treatment of systemic fungal infections and high-risk patients, especially with severe hematological or oncological conditions. Up to date, there are no reliable and systematically reported data on the consumption of antifungal substances on a nationwide level available. The presented study gives an update to the previously published multicenter study investigating antifungal consumption in different settings from five university hospital centers in Germany from 2001 to 2003.
Methods:
Consumption data for systemic antifungal drugs were obtained through the hospital pharmacies for 2001-2003 and 2008-2011 regarding the medical and surgical services of five university hospital centers in Germany (A-E). Drug use densities were calculated as yearly RDDs/100 patient days. These calculations were performed for the surgical and medical services, and independently for surgical and medical ICUs, as well as for the hematology-oncology services.
Results:
We report an increased utilization of systemic antifungal drugs in both study periods. The mean drug use density (mean value of all 5 hospitals) in the medical services increased by 24% between 2001 and 2003. In 2011, this value was 37% above the level from 2001 (12.4 RDD/100 patient days in 2001, 15.4 RDD/100 patient days in 2003, 17.0 RDD/100 patient days in 2011). The 4-year average drug use density (2008-2011) of medical services ranged between 11.6 RDD/100 patient days (hospital E) and 23.8 RDD/100 patient days (hospital A). Drug use densities were in medical intensive care units 29.4 RDD/100 patient days and hematology-oncology services 49.9 RDD/100 patient days.
Conclusions:
Despite the variability of the prescribing patterns between the tertiary hospitals, the presented pharmaco-epidemiological data are a cornerstone for the initiation and implementation of effective antifungal stewardship programmes and might serve as important benchmarking information for other hospitals with similar structures and baseline settings.
Insights
Antifungal drug use significantly increased from 2001-2011 in German hospitals, particularly in intensive care and hematology-oncology. This data is crucial for developing antifungal stewardship programs.
Area of Science:
- Pharmacoepidemiology
- Infectious Diseases
- Antimicrobial Stewardship
Background:
- Rising antifungal consumption poses a pharmaco economic burden and contributes to resistant organisms.
- Systemic antifungal drugs are vital for high-risk patients, especially in hematology-oncology.
- Nationwide data on antifungal consumption is scarce, necessitating updated studies.
Purpose of the Study:
- To update previous findings on antifungal drug consumption in German university hospitals.
- To analyze trends in antifungal utilization between 2001-2003 and 2008-2011.
- To provide benchmarking data for antifungal stewardship initiatives.
Main Methods:
- Consumption data for systemic antifungals collected from hospital pharmacies in five German university hospitals.
- Data analyzed for medical, surgical, ICU, and hematology-oncology services.
- Drug use density calculated as yearly RDDs/100 patient days.
Main Results:
- Systemic antifungal drug utilization showed a significant increase across both study periods.
- Mean drug use density in medical services rose by 37% from 2001 to 2011.
- Highest drug use densities observed in hematology-oncology services (49.9 RDD/100 patient days) and medical ICUs (29.4 RDD/100 patient days).
Conclusions:
- Prescribing patterns for antifungals vary among tertiary hospitals.
- Pharmaco-epidemiological data are essential for implementing effective antifungal stewardship programs.
- The study provides valuable benchmarking data for hospitals with similar structures.
