- Title
- Audit of intravenous antifungal therapy used for Candida infections at a South African private hospital
- Creator
- Van Dyk, Jacklyn Kate
- Subject
- Candidiasis
- Date Issued
- 2020
- Date
- 2020
- Type
- Thesis
- Type
- Masters
- Type
- MPharm
- Identifier
- http://hdl.handle.net/10948/46380
- Identifier
- vital:39600
- Description
- The epidemiological landscape of the candida species has changed with the emergence of MDR strains globally and in South Africa. The aim of this study was to critically evaluate the compliance to guidelines in the use of intravenous antifungal therapy when treating invasive Candidainfections in a South African private hospital.Objective One was to determine the prevalence of Candida auris(C.auris) in the sample. Objective Two examined the relationship between high-risk patients and positive microbiological cultures. Objective Three studied the prescribing utilisation of the intravenous antifungalsin the form of a clinical audit. Objective Four compared these prescribing patternsto current guidelines by evaluating whether the antifungal course was non-compliant, of suboptimal compliance or compliant. Objective Five was to design a protocol for ward pharmacists to use when assessing antifungal treatment for candidiasis. The research design consisted of a retrospective, non-experimental, cross-sectional analysis of intravenous antifungal use in the management of systemic Candida infections in a private sector hospital in the Gauteng province, South Africa.A positive research paradigm with a quantitative clinical audit was used in this study. The most prevalent species cultured was C.auris with 31 of the 77 positive cultures. Risk stratifying patients was validated with 70% of high risk patients (Candida Score >2.5 and positive β-D-glucan) having a corresponding positive culture. Echinocandins were the most frequently utilised antifungal class, with caspofungin being the most used antifungal in the sample. The average duration of therapy for the echinocandins ranged between 11 and 16 days. Compliance to guidelines was evaluated accordingto: reason for initiation; drug choice and drug dose. Three levels of compliance were determined: non-compliant, sub-optimal compliance and compliant. xivThe overall compliance,according to recommended treatment guidelines,was found to be suboptimal, with anidentified need foranintervention which targets thedosing of the antifungals used. In conclusion, the research findings highlight the importance of reviewing antifungal prescribing habits and the need for antifungal stewardship programmes.
- Format
- xvi, 114 leaves
- Format
- Publisher
- Nelson Mandela University
- Publisher
- Faculty of Health Sciences
- Language
- English
- Rights
- Nelson Mandela University
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| Thumbnail | File | Description | Size | Format | |||
|---|---|---|---|---|---|---|---|
| View Details Download | SOURCE1 | van Dyk, JK 211051454 Dissertation April 2020.pdf | 2 MB | Adobe Acrobat PDF | View Details Download |