Please use this identifier to cite or link to this item: https://repository.monashhealth.org/monashhealthjspui/handle/1/52542
Title: Use of echinocandin outpatient parenteral antimicrobial therapy for the treatment of infection caused by Candida spp.: utilization, outcomes and impact of a change to weekly dosing.
Authors: Clarke F.;Grenfell A.;Chao S.;Richards H.;Korman T. ;Rogers B. 
Monash Health Department(s): Infectious Diseases and Clinical Microbiology
Monash University - School of Clinical Sciences at Monash Health
Pharmacy
Hospital in the Home
Centre for Inflammatory Diseases at Monash Health
Institution: (Clarke, Korman, Rogers) Monash Infectious Diseases, Monash Health, Clayton, VIC, Australia
(Grenfell) Monash Health, Clayton, VIC, Australia
(Chao) Pharmacy Department, Monash Health, Clayton, VIC, Australia
(Richards, Rogers) Hospital in the Home, Monash Health, Clayton, VIC, Australia
(Korman) Department of Microbiology, Monash Health, Clayton, VIC, Australia
(Korman, Rogers) Centre for Inflammatory Diseases, Monash University School of Clinical Sciences at Monash Health, Clayton, VIC, Australia
Issue Date: 19-Sep-2024
Copyright year: 2024
Place of publication: United Kingdom
Publication information: The Journal of Antimicrobial Chemotherapy. (no pagination), 2024. Date of Publication: 11 Sep 2024.
Journal: The Journal of Antimicrobial Chemotherapy
Abstract: BACKGROUND: Outpatient parenteral antimicrobial therapy (OPAT) can deliver extended parenteral treatment of fungal infections in an ambulatory setting, whilst minimizing treatment burden and cost. The extended dosing interval of rezafungin may potentiate the benefits of OPAT. METHOD(S): This retrospective cohort study includes all adult patients who received echinocandin therapy in a large OPAT programme between 2012 and 2022. Patient characteristics, treatment and outcomes were studied. Data were analysed to determine the effects of replacing daily dosing with weekly dosing of echinocandin. RESULT(S): Across the study period, 11% (44/386) of all patients in our Health Service treated with >=7 days of echinocandin were managed via OPAT. All were Candida and related 'yeast-like' species infections. Nakaseomyces glabrata (20/41; 49%) was the most common pathogen, fungaemia the most common presentation (17/41; 41%) and azole resistance the most frequent indication for echinocandin use (21/41; 51%).In total, 633 days of echinocandin were administered as OPAT. Thirteen patients (13/41; 32%) received concurrent parenteral antibacterials. Treatment success was achieved in 30/41 (73%) patients. If daily echinocandin dosing was replaced with weekly dosing, a potential 52% (633 to 326) reduction in the total number of treatments (for any therapy) delivered by the OPAT team is possible. The ongoing need for daily antibacterial administration mitigated the benefit in some of this cohort. CONCLUSION(S): Echinocandin therapy can be safely delivered via OPAT with outcomes equivalent to bed-based care. The extended dosing interval of rezafungin will allow for a substantial reduction in the number of treatments required across the patient cohort.Copyright © The Author(s) 2024. Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy.
DOI: http://monash.idm.oclc.org/login?url=https://dx.doi.org/10.1093/jac/dkae302
PubMed URL: 39259571 [https://www.ncbi.nlm.nih.gov/pubmed/?term=39259571]
URI: https://repository.monashhealth.org/monashhealthjspui/handle/1/52542
Type: Article
Subjects: antibacterial activity
antimicrobial activity
antimicrobial therapy
fungemia
Type of Clinical Study or Trial: Observational study (cohort, case-control, cross sectional, or survey)
Appears in Collections:Articles

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