Evaluation of Candida bloodstream infection and antifungal utilization in a tertiary care hospital

Marins, Tatiana Aporta; Marra, Alexandre R.; Edmond, Michael B.; Martino, Marines Dalla Valle; Yokota, Paula Kiyomi Onaga; Mafra, Ana Carolina Cintra Nunes; Durão Junior, Marcelino Souza

doi:10.1186/s12879-018-3094-9

BMC Infectious Diseases

Table 1 Median antifungal consumption in hospital units between 2008 and 2016

From: Evaluation of Candida bloodstream infection and antifungal utilization in a tertiary care hospital

Drug\Unit	MSC	Onco	Ped	AICU	BMT	TX	NICU	P Value*
DDD per 1000 patient-days
Amphotericin B (lipos + deox)	14.2	190.9		239.4	359.0	79.2		< 0.001
P Value		0.002		0.002	0.002	0.045
Amphotericin B liposomal	13.8	190.9		237.5	351.3	78.9		< 0.001
P Value		0.002		0.002	0.002	0.110
Amphotericin B deoxycholate	0.4	0.0		3.2	0.0	7.9		0.012
P Value		0.904		0.110	0.940	0.135
Anidulafugin (2010–2016)	1.4	11.6		20.0	6.2	0.0		0.002
P Value		0.009		0.009	0.995	0.568
Caspofungin	7.2	28.1		73.3	46.7	2.0		< 0.001
P Value		0.007		0.002	0.057	0.110
Fluconazole (IV + PO)	35.7	257.9		160.7	625.6	159.2		< 0.001
P Value		0.002		0.002	0.002	0.002
Fluconazole L IV	25.3	163.3		150.7	382.3	52.6		< 0.001
P Value		0.002		0.002	0.002	0.002
Fluconazole PO	11.4	124.9		14.3	134.2	102.8		< 0.001
P Value		0.002		0.035	0.002	0.002
Itraconazole	0.7	2.7		0.6	0.00	14.7		0.001
P Value		0.625		0.690	0.006	0.324
Micafungina (2011–2016)	3.7	41.8		71.7	153.6	21.2		0.001
P Value		0.020		0.077	0.020	0.224
Posaconazole (2016)	0.0	44.4		6.9	87.3	0.0		–
Voriconazole (IV + PO)	3.1	82.6		22.2	174.4	7.1		< 0.001
P Value		0.002		0.002	0.002	0.495
Voriconazole IV	1.7	44.4		16.0	83.0	3.7		< 0.001
P Value		0.002		0.002	0.002	0.993
Voriconazole PO	1.4	42.4		5.4	80.6	3.4		< 0.001
P Value		0.002		0.007	0.002	0.324
DOT per 1000 patient-days
Amphotericin B (lipos + deox)	3.2	29.8	20.2	38.9	85.2	16.0	2.6	< 0.001
P Value		0.002	0.016	0.002	0.002	0.016	0.943
Amphotericin B liposomal	2.5	29.8	19.7	36.0	82.8	10.8	0.5	< 0.001
P Value		0.002	0.004	0.002	0.002	0.134	0.069
Amphotericin B deoxycholate	0.4	0.0	0.0	1.6	0.0	5.2	1.1	< 0.001
P Value		0.745	0.100	0.045	0.966	0.028	0.434
Anidulafugin (2010–2016)	1.3	11.2	0.0	18.4	5.4	0.0	0.0	< 0.001
P Value		0.009	0.377	0.009	0.995	0.568	0.005
Caspofungin	7.0	27.0	15.0	65.4	45.9	1.8	0.0	< 0.001
P Value		0.007	0.057	0.002	0.089	0.057	0.001
Fluconazole (IV + PO)	42.9	237.0	41.5	147.7	420.1	174.4	1.1	< 0.001
P Value		0.002	0.984	0.002	0.002	0.002	0.002
Fluconazole L IV	23.4	102.0	29.8	126.7	259.4	51.1	1.1	< 0.001
P Value		0.002	0.690	0.002	0.002	0.002	0.002
Fluconazole PO	20.1	130.4	13.2	23.6	160.6	119.7	0.0	< 0.001
P Value		0.002	0.057	0.434	0.002	0.002	0.001
Itraconazole	0.8	1.2	1.0	0.8	0.0	11.8	0.0	< 0.001
P Value		0.753	1.000	0.812	0.008	0.324	0.001
Micafungina (2011–2016)	3.9	45.3	8.5	73.5	225.5	21.8	0.0	< 0.001
P Value		0.020	0.624	0.077	0.020	0.224	0.024
Posaconazole (2016)	0.0	3.1	0.0	0.5	6.2	0.0	0.0	–
Voriconazole (IV + PO)	5.4	130.1	35.0	25.4	322.3	10.1	0.00	< 0.001
P Value		0.002	0.002	0.002	0.002	0.559	0.001
Voriconazole IV	2.6	57.2	14.0	20.1	142.7	4.7	0.00	< 0.001
P Value		0.002	0.002	0.002	0.002	0.984	0.001
Voriconazole PO	2.2	73.7	17.7	7.1	147.7	5.6	0.00	< 0.001
P Value		0.002	0.028	0.002	0.002	0.276	0.001

DDD Defined Daily Dose, DOT Days of Therapy, IV Intravenous, PO Oral, MSW Medical and Surgical Wards, Onco Oncology, Ped Pediatrics, AICU Adult Intensive Care Unit, BTM Bone marrow transplant, SOT Solid organ transplant, NICU Neonatal Intensive Care Unit *P values for Kruskal-Wallis tests to test whether in at least one of the units the consumption was different from the others. Other p-values for post-tests with Steel correction that compare each unit with the Medical and Surgical Wards

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