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737. A Descriptive Analysis of Fluconazole Utilization at Two Academic Medical Centers in the Valley Fever Corridor of Arizona

BACKGROUND: Fluconazole (fluc) is a common antifungal used at hospitals and is an important target for antimicrobial stewardship (AS). Fluc is also used for management of coccidioidomycosis (C). The objective of our study was to describe fluc prescribing patterns at two academic centers in Arizona....

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Autores principales: Hayes, Justin, Matthias, Kathryn, Villanueva, Juan, Nix, David
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7777693/
http://dx.doi.org/10.1093/ofid/ofaa439.928
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author Hayes, Justin
Matthias, Kathryn
Villanueva, Juan
Nix, David
author_facet Hayes, Justin
Matthias, Kathryn
Villanueva, Juan
Nix, David
author_sort Hayes, Justin
collection PubMed
description BACKGROUND: Fluconazole (fluc) is a common antifungal used at hospitals and is an important target for antimicrobial stewardship (AS). Fluc is also used for management of coccidioidomycosis (C). The objective of our study was to describe fluc prescribing patterns at two academic centers in Arizona. METHODS: We conducted a retrospective analysis of fluc usage in adult patients. One month from each quarter in a one-year period (November 2017-November 2018) was selected (4 months in total). All adult patients that received fluc at Hospital A and Hospital B in the selected months were identified. Patient demographic information and Charlson comorbidity index (CCI) to quantify the degree of comorbidity were collected. We then analyzed patients in the study by defining the fluc usage as directed towards C management or non-C management (e.g., candidiasis). In the C management group, we characterized the initial fluc dose during the patient’s course as directed for empiric, targeted, or prophylaxis treatment. Finally, we performed further analysis of the empiric C group. The study received IRB approval from our institution. RESULTS: During our study period, 1239 patients were included in the analysis. Patient information is shown in Table 1. Overall, most of the fluc usage was directed towards C management (63.5%, 787/1239). A significant amount of that usage was directed towards C prophylaxis at both Hospital A and B (67.4% (234/347) and 75% (330/440), respectively). In addition, fluc usage directed towards empiric C management was higher at Hospital A versus Hospital B (18.4% (64/347) versus 9.5% (42/440), respectively). Further patient data for the empiric C group is shown in Table 2. [Image: see text] [Image: see text] CONCLUSION: We report the results of a descriptive study that demonstrate that 63.5% of fluc usage in adults at two academic medical centers in Arizona was directed for C management. In addition to traditional fluc targets for AS, our study highlights C prophylaxis in solid organ transplant recipients and empiric C management as AS targets in endemic regions. These targets are especially important due to the risk for selection of azole-resistant Candida species and invasive molds with increased antifungal exposure. DISCLOSURES: All Authors: No reported disclosures
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spelling pubmed-77776932021-01-07 737. A Descriptive Analysis of Fluconazole Utilization at Two Academic Medical Centers in the Valley Fever Corridor of Arizona Hayes, Justin Matthias, Kathryn Villanueva, Juan Nix, David Open Forum Infect Dis Poster Abstracts BACKGROUND: Fluconazole (fluc) is a common antifungal used at hospitals and is an important target for antimicrobial stewardship (AS). Fluc is also used for management of coccidioidomycosis (C). The objective of our study was to describe fluc prescribing patterns at two academic centers in Arizona. METHODS: We conducted a retrospective analysis of fluc usage in adult patients. One month from each quarter in a one-year period (November 2017-November 2018) was selected (4 months in total). All adult patients that received fluc at Hospital A and Hospital B in the selected months were identified. Patient demographic information and Charlson comorbidity index (CCI) to quantify the degree of comorbidity were collected. We then analyzed patients in the study by defining the fluc usage as directed towards C management or non-C management (e.g., candidiasis). In the C management group, we characterized the initial fluc dose during the patient’s course as directed for empiric, targeted, or prophylaxis treatment. Finally, we performed further analysis of the empiric C group. The study received IRB approval from our institution. RESULTS: During our study period, 1239 patients were included in the analysis. Patient information is shown in Table 1. Overall, most of the fluc usage was directed towards C management (63.5%, 787/1239). A significant amount of that usage was directed towards C prophylaxis at both Hospital A and B (67.4% (234/347) and 75% (330/440), respectively). In addition, fluc usage directed towards empiric C management was higher at Hospital A versus Hospital B (18.4% (64/347) versus 9.5% (42/440), respectively). Further patient data for the empiric C group is shown in Table 2. [Image: see text] [Image: see text] CONCLUSION: We report the results of a descriptive study that demonstrate that 63.5% of fluc usage in adults at two academic medical centers in Arizona was directed for C management. In addition to traditional fluc targets for AS, our study highlights C prophylaxis in solid organ transplant recipients and empiric C management as AS targets in endemic regions. These targets are especially important due to the risk for selection of azole-resistant Candida species and invasive molds with increased antifungal exposure. DISCLOSURES: All Authors: No reported disclosures Oxford University Press 2020-12-31 /pmc/articles/PMC7777693/ http://dx.doi.org/10.1093/ofid/ofaa439.928 Text en © The Author 2020. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Poster Abstracts
Hayes, Justin
Matthias, Kathryn
Villanueva, Juan
Nix, David
737. A Descriptive Analysis of Fluconazole Utilization at Two Academic Medical Centers in the Valley Fever Corridor of Arizona
title 737. A Descriptive Analysis of Fluconazole Utilization at Two Academic Medical Centers in the Valley Fever Corridor of Arizona
title_full 737. A Descriptive Analysis of Fluconazole Utilization at Two Academic Medical Centers in the Valley Fever Corridor of Arizona
title_fullStr 737. A Descriptive Analysis of Fluconazole Utilization at Two Academic Medical Centers in the Valley Fever Corridor of Arizona
title_full_unstemmed 737. A Descriptive Analysis of Fluconazole Utilization at Two Academic Medical Centers in the Valley Fever Corridor of Arizona
title_short 737. A Descriptive Analysis of Fluconazole Utilization at Two Academic Medical Centers in the Valley Fever Corridor of Arizona
title_sort 737. a descriptive analysis of fluconazole utilization at two academic medical centers in the valley fever corridor of arizona
topic Poster Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7777693/
http://dx.doi.org/10.1093/ofid/ofaa439.928
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