title: Implementation of practice guidelines for antifungal therapy in a surgical intensive care unit and its impact on use and costs.
abstract: BACKGROUND
  Considering the complexity of diagnosis, high costs of therapy and high morbidity and mortality of systemic fungal infections, antifungal therapy of intensive care patients should follow clearly defined guidelines. We outline the impact of a standardised practice of antifungal treatment in an interdisciplinary surgical intensive care unit of a university hospital.
  
  
  METHODS
  Therapy was intended to be optimised by implementation of standardised practice guidelines supported by the clinical pharmacist. Costs for antifungal agents during a period of 18 months before and after implementation of the practice guidelines were compared, respectively.
  
  
  RESULTS
  The intervention was associated with a significant decrease in use of antifungal agents. Analysis of data revealed a reduction in costs by 50%. This could substantially be attributed to the implementation of the practice guidelines.
  
  
  CONCLUSIONS
  The implementation of standardised practice guidelines for antifungal therapy in intensive care units decreased the use of selected antifungal agents and resulted in substantial reduction in expenditure on antifungal agents.
authors.affiliation: Department of Pharmacy, University Hospital of Heidelberg, Heidelberg, Germany. stefanie.swoboda@med.uni-heidelberg.de
authors.forename: Stefanie
authors.initials: S
authors.lastname: Swoboda
authors.forename: Christoph
authors.initials: C
authors.lastname: Lichtenstern
authors.forename: Michael Christoff
authors.initials: MC
authors.lastname: Ober
authors.forename: Lenka Alexandra
authors.initials: LA
authors.lastname: Taylor
authors.forename: Dominic
authors.initials: D
authors.lastname: Störzinger
authors.forename: André
authors.initials: A
authors.lastname: Michel
authors.forename: Angelika
authors.initials: A
authors.lastname: Brobeil
authors.forename: Markus
authors.initials: M
authors.lastname: Mieth
authors.forename: Stefan
authors.initials: S
authors.lastname: Hofer
authors.forename: Hans-Günther
authors.initials: HG
authors.lastname: Sonntag
authors.forename: Torsten
authors.initials: T
authors.lastname: Hoppe-Tichy
authors.forename: Markus Alexander
authors.initials: MA
authors.lastname: Weigand
mesh_terms: D000935:Antifungal Agents / Q000008:administration & dosage* / Q000191:economics / Q000627:therapeutic use; D003422:Critical Care / Q000191:economics / Q000458:organization & administration*; D016527:Drug Costs; D017850:Economics, Pharmaceutical; D005260:Female; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000188:drug therapy*; D010595:Pharmacists / Q000458:organization & administration; D017410:Practice Guidelines as Topic; D024382:Professional Role
chemical_list: D000935:Antifungal Agents