Utilization Status And Rationality Analysis Of Deep Anti-fungal Agents In One Hospital

Objective:To investigate the current situation and developing trend of deep Anti-fungal Agents in one hospital for successive3years, the present study was designed to evaluate the drug application and analyze the influential factors of irrational utilization, so as to provide reasonable evidence for rational use of deep Anti-fungal Agents in clinic practice.Methods:1. Deep Anti-fungal Agents used from2010to2012were analyzed based on the parameters of consumption sum rankings, defined daily doses rankings, drug utilization index, defined daily dose consumption, etc.2. Taking In-patients who have used Anti-fungal Agents for at least once during Apr.2010～Apr.2012as objects, we retrospectively reviewed the cases selected via random sampling, observed the clinical utilization as well as assessing the appropriateness of those drugs.3. Unconditional logistic regression analysis was used to analyze the influencing factors of irrational drug utilization via the SPSS(version16.0) statistical packages.Results:1. The total consumption sum of Anti-fungal Agents saw a sustainable growth within2010～2012, but the annual growth rate dropped dramatically from53.3%in2010～2011to2.2%in2011～2012. Costs of Triazole antifungal agents were the main contributor to the total consumption sum of deep Anti-fungal Agents, accounting for83.5%,73.2%and59.8%respectively during the successive3years.2. The total DDDs rose by68.6%in2010～2011while declined by11.8%in2011～2012. DDDs of Triazole antifungal agents were also the main components of the total DDDs of deep Anti-fungal Agents, accounting for88.5%,90.5%and81.8%respectively during the successive3years.3.1218cases were investigated, of which the irrational utilization of deep Anti-fungal Agents accounted for31.6%(385/1218).Drugs arranged by respective rate of irrational utilization were Voriconazole(59.6%), Fluconazole (36.6%), Itraconazole(18.6%), Amphotericin B(15.0%) and Caspofungin (4.5%).4. Before and after the National During Rectification of Antimicrobial Drugs, irrational utilization rate of deep Anti-fungal Agents dropped from37.9%to25.0%in this hospital.5. The intensive manifestation of irrational utilization were inappropriate dosing frequency(8.0%), misoperation of loading dosage(7.5%), no loading dosage(6.4%) and no indication(4.9%).6. Multivariate unconditional Logistic regression indicated immunological condition and treatment purpose were positive correlate with irrational utilization rate, which meant that patients on immunocompetent condition and of therapeutic drug use had higher irrational utilization rate.Conclusion:1. The total consumption sum and DDDs rose during2010-2011, while during2011～2012the annual growth rate of total consumption sum dropped dramatically and the total DDDs even showed negative growth. Triazole antifungal agents were the most widely used among various deep Anti-fungal Agents.2. The irrational use of deep Anti-fungal Agents accounted for31.6%, intensive manifestation of irrational utilization were nappropriate dosing frequency, misoperation of loading dosage, no loading dosage and no indication. Patients on immunocompetent condition and of therapeutic drug use had higher irrational utilization rate, each was respectively presented as no indication and no loading dosage.3. During the National Rectification of Antimicrobial Drugs, irrational use of deep Anti-fungal Agents had been controlled to some extents, however, continuously enhanced management of the health administration was still needed. Besides, Clinical Pharmacist should play a guiding role to promote the rational use of deep Anti-fungal Agents cohesively.