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Utility of 1,3 β-d-Glucan Assay for Guidance in Antifungal Stewardship Programs for Oncologic Patients and Solid Organ Transplant Recipients
The implementation of 1,3 β-d-glucan (BDG) has been proposed as a diagnostic tool in antifungal stewardship programs (ASPs). We aimed to analyze the influence of serum BDG in an ASP for oncologic patients and solid organ transplant (SOT) recipients. We conducted a pre–post study. In the initial peri...
Autores principales: | , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7830184/ https://www.ncbi.nlm.nih.gov/pubmed/33477250 http://dx.doi.org/10.3390/jof7010059 |
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author | Machado, Marina Chamorro de Vega, Esther Martínez-Jiménez, María del Carmen Rodríguez-González, Carmen Guadalupe Vena, Antonio Navarro, Raquel Zamora-Cintas, María Isabel Agnelli, Caroline Olmedo, María Galar, Alicia Guinea, Jesús Fernández-Cruz, Ana Alonso, Roberto Bouza, Emilio Muñoz, Patricia Valerio, Maricela |
author_facet | Machado, Marina Chamorro de Vega, Esther Martínez-Jiménez, María del Carmen Rodríguez-González, Carmen Guadalupe Vena, Antonio Navarro, Raquel Zamora-Cintas, María Isabel Agnelli, Caroline Olmedo, María Galar, Alicia Guinea, Jesús Fernández-Cruz, Ana Alonso, Roberto Bouza, Emilio Muñoz, Patricia Valerio, Maricela |
author_sort | Machado, Marina |
collection | PubMed |
description | The implementation of 1,3 β-d-glucan (BDG) has been proposed as a diagnostic tool in antifungal stewardship programs (ASPs). We aimed to analyze the influence of serum BDG in an ASP for oncologic patients and solid organ transplant (SOT) recipients. We conducted a pre–post study. In the initial period (PRE), the ASP was based on bedside advice, and this was complemented with BDG in the post-period (POST). Performance parameters of the BDG assay were determined. Antifungal (AF) use adequacy was evaluated using a point score. Clinical outcomes and AF costs were also compared before and after the intervention. Overall, 85 patients were included in the PRE-period and 112 in the POST-period. Probable or proven fungal infections were similar in both groups (54.1% vs. 57.1%; p = 0.67). The determination of BDG contributed to improved management in 75 of 112 patients (66.9%). The AF adequacy score improved in the POST-period (mean 7.75 vs. 9.29; p < 0.001). Median days of empiric AF treatment was reduced in the POST-period (9 vs. 5 days, p = 0.04). All-cause mortality (44.7% vs. 34.8%; p = 0.16) was similar in both periods. The cost of AF treatments was reduced in the POST-period with a difference of 779.6 €/patient. Our data suggest that the use of BDG was a cost-effective strategy that contributed to safely improving the results of an ASP for SOT and oncologic patients. |
format | Online Article Text |
id | pubmed-7830184 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-78301842021-01-26 Utility of 1,3 β-d-Glucan Assay for Guidance in Antifungal Stewardship Programs for Oncologic Patients and Solid Organ Transplant Recipients Machado, Marina Chamorro de Vega, Esther Martínez-Jiménez, María del Carmen Rodríguez-González, Carmen Guadalupe Vena, Antonio Navarro, Raquel Zamora-Cintas, María Isabel Agnelli, Caroline Olmedo, María Galar, Alicia Guinea, Jesús Fernández-Cruz, Ana Alonso, Roberto Bouza, Emilio Muñoz, Patricia Valerio, Maricela J Fungi (Basel) Article The implementation of 1,3 β-d-glucan (BDG) has been proposed as a diagnostic tool in antifungal stewardship programs (ASPs). We aimed to analyze the influence of serum BDG in an ASP for oncologic patients and solid organ transplant (SOT) recipients. We conducted a pre–post study. In the initial period (PRE), the ASP was based on bedside advice, and this was complemented with BDG in the post-period (POST). Performance parameters of the BDG assay were determined. Antifungal (AF) use adequacy was evaluated using a point score. Clinical outcomes and AF costs were also compared before and after the intervention. Overall, 85 patients were included in the PRE-period and 112 in the POST-period. Probable or proven fungal infections were similar in both groups (54.1% vs. 57.1%; p = 0.67). The determination of BDG contributed to improved management in 75 of 112 patients (66.9%). The AF adequacy score improved in the POST-period (mean 7.75 vs. 9.29; p < 0.001). Median days of empiric AF treatment was reduced in the POST-period (9 vs. 5 days, p = 0.04). All-cause mortality (44.7% vs. 34.8%; p = 0.16) was similar in both periods. The cost of AF treatments was reduced in the POST-period with a difference of 779.6 €/patient. Our data suggest that the use of BDG was a cost-effective strategy that contributed to safely improving the results of an ASP for SOT and oncologic patients. MDPI 2021-01-17 /pmc/articles/PMC7830184/ /pubmed/33477250 http://dx.doi.org/10.3390/jof7010059 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Machado, Marina Chamorro de Vega, Esther Martínez-Jiménez, María del Carmen Rodríguez-González, Carmen Guadalupe Vena, Antonio Navarro, Raquel Zamora-Cintas, María Isabel Agnelli, Caroline Olmedo, María Galar, Alicia Guinea, Jesús Fernández-Cruz, Ana Alonso, Roberto Bouza, Emilio Muñoz, Patricia Valerio, Maricela Utility of 1,3 β-d-Glucan Assay for Guidance in Antifungal Stewardship Programs for Oncologic Patients and Solid Organ Transplant Recipients |
title | Utility of 1,3 β-d-Glucan Assay for Guidance in Antifungal Stewardship Programs for Oncologic Patients and Solid Organ Transplant Recipients |
title_full | Utility of 1,3 β-d-Glucan Assay for Guidance in Antifungal Stewardship Programs for Oncologic Patients and Solid Organ Transplant Recipients |
title_fullStr | Utility of 1,3 β-d-Glucan Assay for Guidance in Antifungal Stewardship Programs for Oncologic Patients and Solid Organ Transplant Recipients |
title_full_unstemmed | Utility of 1,3 β-d-Glucan Assay for Guidance in Antifungal Stewardship Programs for Oncologic Patients and Solid Organ Transplant Recipients |
title_short | Utility of 1,3 β-d-Glucan Assay for Guidance in Antifungal Stewardship Programs for Oncologic Patients and Solid Organ Transplant Recipients |
title_sort | utility of 1,3 β-d-glucan assay for guidance in antifungal stewardship programs for oncologic patients and solid organ transplant recipients |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7830184/ https://www.ncbi.nlm.nih.gov/pubmed/33477250 http://dx.doi.org/10.3390/jof7010059 |
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