Biblioteca Origen csic Identificador doi: 10.1016/j.jinf.2020.01.002 Identificador issn: 0163-4453 Identificador Journal of Infection 80(3): 342-349 (2020) Identificador http://hdl.handle.net/10261/232395 Identificador 10.1016/j.jinf.2020.01.002 Identificador http://dx.doi.org/10.13039/501100011011 Título Efficacy and safety of a comprehensive educational antimicrobial stewardship program focused on antifungal use Autor Martín-Gutiérrez, Guillermo Autor Peñalva-Moreno, Germán Autor Ruiz-Pérez de Pipaón, Maite Autor Aguilar Guisado, Manuela Autor Gil-Navarro, María Victoria Autor Pérez-Blanco, José Luis Autor Pérez-Moreno, María Antonia Autor Amaya-Villar, Rosario Autor Ferrándiz-Millón, Carmen Autor Gascón, María L. Autor Goycochea-Valdivia, Walter Alfredo Autor Jiménez-Mejías, M. E. Autor Navarro-Amuedo, María Dolores Autor Lepe, José A. Autor Álvarez-Marín, Rocío Autor Neth, Olaf Autor Guisado-Gil, Ana Belén Autor Infante-Domínguez, Carmen Autor Molina Gil-Bermejo, José Autor Cisneros, José Miguel Resumen [Objective] Few data exist regarding the impact of antimicrobial stewardship programs on antifungal use. We evaluated the efficacy and safety of a comprehensive long-term antimicrobial stewardship program (ASP) focused on antifungal use. | [Methods] During a 9-year period, we quarterly assessed antifungal consumption, incidence density of hospital-acquired candidemia, Candida spp. distribution, antifungal resistance, and crude death rate per 1000 occupied bed days (OBDs) of hospital-acquired candidemia. We performed segmented regression analysis of interrupted time series. | [Results] A significant change in trend was observed for antifungal consumption, with a sustained reduction of -0.87% per quarter (95% confidence interval [CI], −1.36 −0.38, p < 0.001), accounting for a final reduction of −38.4%. The main reduction was produced in fluconazole, with a sustained reduction of −1.37% per quarter (95%CI, −1.96 −0.68, p<0.001). The incidence density of hospital-acquired candidemia decreased, with a change in slope of −5.06% cases per 1000 OBDs per year (95%CI, −8.23 −1.77, p = 0.009). The 14-day crude death rate per 1000 OBDs dropped from 0.044 to 0.017 (−6.36% deaths per 1000 OBDs per year; 95%CI, −13.45 −1.31, p = 0.09). | [Conclusions] This ASP has succeeded in optimizing the use of antifungal with a long-lasting reduction without increasing the incidence, neither the mortality, of hospital-acquired candidemia. | The program received public funding from the Regional Health Ministry of Andalucía (Grant PI-0361-2010), which did not participate in the development of the program or the analysis of its results. Editor Elsevier Contribuidor Junta de Andalucía Fecha de Publicación 2021-03-03T11:10:45Z | 2021-03-03T11:10:45Z | 2020-03 | 2021-03-03T11:10:46Z Tipo artículo | http://purl.org/coar/resource_type/c_6501 Relación http://doi.org/10.1016/j.jinf.2020.01.002 | Sí Derechos none Información OAI   ID oai:digital.csic.es:10261/232395 Última Modificación 2022-03-24