title: [Adequacy of antifungal agents in a teaching hospital: too many inappropriate prescriptions despite training].
abstract: OBJECTIVE
  The aim of this study was to assess adequacy and conformity of systemic antifungal drugs prescriptions in comparison with local, French, European and international recent guidelines in the Grenoble Teaching Hospital.
  
  
  METHODS
  Each prescription of itraconazole, liposomal amphotericin B, voriconazole, caspofungin, micafungin, posaconazole and anidulafungin made between February and October 2010 were reviewed by an infectious diseases specialist. Fluconazole prescriptions' were reviewed only for 15 days.
  
  
  RESULTS
  Two hundred and eight patients received 295 systemic antifungal prescriptions. Most of them had at least one risk factor and immunodeficiency was one of the most common. Antifungal treatment starting, molecules choice, administrations conformity (dosage, administration way) were appropriate in 126 cases on 208 (60.5 %) at the treatment beginning evaluation and in 171 cases on 295 (58 %) at the treatment ending evaluation. Antifungal combinations (9.4 %) were less frequent than in the study carried out in Grenoble teaching hospital in 2007 (16.3 %). Most common non-conformities encountered were use of caspofungin instead of fluconazole, antifungal combinations prescription, administration modalities misguiding. The economy that could have been generated by appropriate prescriptions represented 18 % of the antifungal budget of 2010 in the Grenoble Teaching Hospital.
  
  
  CONCLUSIONS
  An improvement was highlighted in the antifungal prescriptions in comparison to the previous study led in 2007 in the Universitary Grenoble Hospital. However, the antifungal use was not optimal and further training is planned.
authors: Université Joseph-Fourier-Grenoble 1, maladies infectieuses, centre hospitalier universitaire de Grenoble, 38700 La Tronche, France. Electronic address: laetitia.fabien38@gmail.com.
authors: Laetitia
authors: L
authors: Fabien
authors: Université Joseph-Fourier-Grenoble 1, pharmacie hospitalière, centre hospitalier universitaire de Grenoble, 38700 La Tronche, France.
authors: Luc
authors: L
authors: Foroni
authors: Université Joseph-Fourier-Grenoble 1, maladies infectieuses, centre hospitalier universitaire de Grenoble, 38700 La Tronche, France.
authors: Jean-Paul
authors: JP
authors: Brion
authors: Université Joseph-Fourier-Grenoble 1, laboratoire de parasitologie, centre hospitalier universitaire de Grenoble, 38700 La Tronche, France.
authors: Danièle
authors: D
authors: Maubon
authors: Université Joseph-Fourier-Grenoble 1, maladies infectieuses, centre hospitalier universitaire de Grenoble, 38700 La Tronche, France.
authors: Jean-Paul
authors: JP
authors: Stahl
authors: Université Joseph-Fourier-Grenoble 1, maladies infectieuses, centre hospitalier universitaire de Grenoble, 38700 La Tronche, France.
authors: Patricia
authors: P
authors: Pavese
mesh_terms: D000328:Adult; D000368:Aged; D000935:Antifungal Agents / Q000008:administration & dosage*; D001228:Aspergillosis / Q000175:diagnosis / Q000188:drug therapy / Q000517:prevention & control; D002177:Candidiasis / Q000175:diagnosis / Q000188:drug therapy / Q000517:prevention & control; D054869:Clinical Audit; D003430:Cross-Sectional Studies; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D004359:Drug Therapy, Combination; D005260:Female; D005334:Fever / Q000382:microbiology; D005602:France; D019983:Guideline Adherence; D006784:Hospitals, Teaching; D006801:Humans; D057970:Inappropriate Prescribing / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D011446:Prospective Studies
chemical_list: D000935:Antifungal Agents