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Hospital use of systemic antifungal drugs: a multi-center surveillance update from Germany

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Abstract

Background

The consumption of antifungal agents increased over the last decade, resulting in the development of resistant organisms and causing a significant pharmaco economic burden. Antifungal drugs are widely used for the treatment of systemic fungal infections and high-risk patients, especially with severe hematological or oncological conditions. Up to date, there are no reliable and systematically reported data on the consumption of antifungal substances on a nationwide level available. The presented study gives an update to the previously published multicenter study investigating antifungal consumption in different settings from five university hospital centers in Germany from 2001 to 2003.

Methods

Consumption data for systemic antifungal drugs were obtained through the hospital pharmacies for 2001–2003 and 2008–2011 regarding the medical and surgical services of five university hospital centers in Germany (A-E). Drug use densities were calculated as yearly RDDs/100 patient days. These calculations were performed for the surgical and medical services, and independently for surgical and medical ICUs, as well as for the hematology–oncology services.

Results

We report an increased utilization of systemic antifungal drugs in both study periods. The mean drug use density (mean value of all 5 hospitals) in the medical services increased by 24 % between 2001 and 2003. In 2011, this value was 37 % above the level from 2001 (12.4 RDD/100 patient days in 2001, 15.4 RDD/100 patient days in 2003, 17.0 RDD/100 patient days in 2011). The 4-year average drug use density (2008–2011) of medical services ranged between 11.6 RDD/100 patient days (hospital E) and 23.8 RDD/100 patient days (hospital A). Drug use densities were in medical intensive care units 29.4 RDD/100 patient days and hematology–oncology services 49.9 RDD/100 patient days.

Conclusions

Despite the variability of the prescribing patterns between the tertiary hospitals, the presented pharmaco-epidemiological data are a cornerstone for the initiation and implementation of effective antifungal stewardship programmes and might serve as important benchmarking information for other hospitals with similar structures and baseline settings.

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Conflict of interest

The authors declare that there is no conflict of interest.

Ethical standard

The ethics committee was notified about the study––formal approval was not required, because the project is based on epidemiological data. Research involving human subjects, human material, specific human or personalized data was not carried out.

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Author notes

    Authors and Affiliations

    1. Pharmacy, University Medical Center Freiburg, Freiburg, Germany

      Barbara N. Gross & Martin J. Hug

    2. Center for Infectious Diseases and Travel Medicine, University Medical Center Freiburg, Freiburg, Germany

      Michaela Steib-Bauert, Winfried V. Kern, Johannes P. Borde & Katja de With

    3. Academic Medical Center Pharmacy, Technical University, Dresden, Germany

      Holger Knoth

    4. Pharmacy Service, Hospital of the Friedrich-Alexander University, Erlangen, Germany

      Sabine Krebs

    5. Pharmacy, University Hospital, Regensburg, Germany

      Ulrich Rothe

    6. Pharmacy, Ulm University Hospital and Medical Center, Ulm, Germany

      Ludwig Maier

    7. Division of Infectious Diseases, University Hospital Carl Gustav Carus, Dresden, Germany

      Katja de With

    Authors
    1. Barbara N. Gross
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    2. Michaela Steib-Bauert
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    3. Winfried V. Kern
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    4. Holger Knoth
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    6. Sabine Krebs
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    7. Martin J. Hug
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    8. Ulrich Rothe
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    9. Ludwig Maier
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    10. Katja de With
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    Corresponding author

    Correspondence to Johannes P. Borde.

    Additional information

    B. N. Gross and J. P. Borde equally contributed to the manuscript.

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    Gross, B.N., Steib-Bauert, M., Kern, W.V. et al. Hospital use of systemic antifungal drugs: a multi-center surveillance update from Germany. Infection 43, 423–429 (2015). https://doi.org/10.1007/s15010-015-0742-5

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    • DOI: https://doi.org/10.1007/s15010-015-0742-5

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