The Utilization Pattern of Caspofungin in an Educational Hospital

Abstract

Background: Caspofungin is prescribed for the systemic treatment of fungal infections and its correct prescription pattern is an issue of importance. Hence in this study Caspofungin utilization and the frequency rate of medication errors were investigated at a training hospital in a developing country.

Methods: This cross-sectional study enrolled 43 consecutive patients receiving Caspofungin in Firoozgar Hospital, Tehran, Iran from March to September 2017.

Results: The prescription frequency was higher in Intensive Care Unit by a rate of 58.1%. Infectious disease specialists were responsible for Caspofungin prescription only in 11 cases (25.5%). The cause of Caspofungin prescription was unknown in 18.6% of cases; but empiric treatment for febrile neutropenia and ICU patients with Candida Score > 2.5 were the most known causes. The drug administration in 11 cases (25.6%) occurred in less than one hour. The indication of treatment was incorrect in 12 out of 43 cases (28%). On the first day of the treatment a dose of both 70 mg and 50 mg was prescribed, which was higher than the appropriate dose and also it was lower than the optimal dose in five cases (83.7%). The mean treatment duration was 10.88 ± 5.35 days ranging from 2 to 24 days. The duration of treatment was correct in 20 cases (46.5%) and incorrect for 23 patients (53.5%).

Conclusion:  In comparison with the Sanford and IDSA Guidelines there are multiple discordances in our setting, such as inappropriate duration, continuation, and indications. Hence these should be announced to the physicians for taking further caution in the aforementioned cases, and it is advisable to consult with infectious diseases specialists for the administration of anti-fungal drugs.

J Pharm Care 2019; 7(3): 57-61.