Implementation of practice guidelines for antifungal therapy in a surgical intensive care unit and its impact on use and costs.
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.
Swoboda
Stefanie
S
Department of Pharmacy, University Hospital of Heidelberg, Heidelberg, Germany. stefanie.swoboda@med.uni-heidelberg.de
Lichtenstern
Christoph
C
Ober
Michael Christoff
MC
Taylor
Lenka Alexandra
LA
Störzinger
Dominic
D
Michel
André
A
Brobeil
Angelika
A
Mieth
Markus
M
Hofer
Stefan
S
Sonntag
Hans-Günther
HG
Hoppe-Tichy
Torsten
T
Weigand
Markus Alexander
MA
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
D000935:Antifungal Agents