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Multicenter Study of the Effectiveness of Antifungal Stewardship Team Intervention for Candidemia in Japan in 2008–2021

Authors :
Mieko Tokano
Norihito Tarumoto
Jun Sakai
Kazuo Imai
Sakaru Koizumi
Haruka Karaushi
Tamotsu Hatanaka
Etsuko Kishi
Masafumi Seki
Koutaro Mitsutake
Shigefumi Maesaki
Source :
Infectious Disease Reports, Vol 16, Iss 2, Pp 356-366 (2024)
Publication Year :
2024
Publisher :
MDPI AG, 2024.

Abstract

Candidemia, linked to high mortality rates, requires prompt antifungal therapy for better outcomes. Treatment is structured as an action bundle, which is beneficial when followed closely. However, the Japanese action bundle lacks detailed guidance on severe complications like endocarditis or ocular issues. To address this, we adjusted the action bundle and assessed outcomes with and without AFT intervention. We strengthened protocols for blood cultures and organ assessments, and the AFT contacted the primary physician when yeast-like fungi were detected in the patient’s blood culture bottles. Analyzing 204 candidemia cases from 2008–2021, we observed increased adherence and reduced mortality post-AFT intervention. Ophthalmology consultations rose significantly, but many patients had only one visit, suggesting inadequate follow-up. If endophthalmitis is diagnosed, a change in the treatment approach may be necessary. There is a possibility that abnormal ocular findings will be detected during subsequent visits, which highlights the need for improvement in ophthalmology follow-up rates as a future challenge for our AFT activities.

Details

Language :
English
ISSN :
20367449
Volume :
16
Issue :
2
Database :
Directory of Open Access Journals
Journal :
Infectious Disease Reports
Publication Type :
Academic Journal
Accession number :
edsdoj.1a8bdba9b0842709dfb65b998b76481
Document Type :
article
Full Text :
https://doi.org/10.3390/idr16020027