Analysis of antifungal therapy in 72 critically ill patients and suggestion for rational medication

ZHOU Ding-xia; WANG Yuan-yuan; XU Yin-li

doi:10.3969/j.issn.1672-8157.2023.06.022

Abstract：Objective:To analyze the antifungal treatment outcomes in 72 critically ill patients and propose optimization strategies from a clinical pharmacy perspective.Methods:A retrospective research approach was used,and data on age,gender,acute physiology and chronic health evaluation scores,ICU stay duration,outcomes,and other relevant information for 72 critically ill patients undergoing antifungal treatment were collected.A statistical analysis was conducted on the usage,dosage,microbiological testing,culture results,G test/GM test submissions,and concurrent use of antibacterial drugs.Results:Fungal culture results were positive in 52 cases,meeting clinical diagnostic criteria for invasive fungal disease.Non-sterile site detections accounted for 84.93%(62/73),with Candida albicans comprising 58.57%(41/70).The duration of antifungal treatment was(11.47±10.74)days,with antibacterial drugs used for(15.42±17.02)days before antifungal treatment.The monotherapy rate for antifungal drugs was 87.5%(63/72),with fluconazole monotherapy accounting for 52.78%(38/72).The rationality rate for antifungal treatment was 44.44%(32/72),with 40 cases deemed irrational.Among them,24 had one irrationality,and 16 had two irrationalities,totaling 56 irrational entries.Based on the current status of antifungal treatment in 72 critically ill patients,three optimization suggestions were proposed from a clinical pharmacy perspective.Conclusion:Challenges in antifungal treatment for critically ill patients include diagnostic difficulties,short treatment durations,and irrational dosages.Individualized medication plans should adhere to the principles of early,sufficient,and complete treatment,with pharmaceutical care implemented throughout the treatment process.