Invasive candidosis: contrasting the perceptions of infectious disease physicians and intensive care physicians

Schultz, Vanessa; Colombo, Arnaldo Lopes; Pasqualotto, Alessandro C.

doi:10.1590/0037-8682-0057-2013

Cited by 2 publications

(1 citation statement)

References 14 publications

(18 reference statements)

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“…Compliance with restrictive antibiotic prescribing may also be perceived as time-consuming [25]. Additionally, primary physicians may perceive that restrictive antibiotic prescribing impinges on their autonomy [26], particularly when the practices of ID physicians and primary physicians diverge [27,28]. When ID physicians consider restrictive interventions, it is important to adopt a persuasive approach to encourage buy-in [29].…”

Section: Discussionmentioning

confidence: 99%

Timeliness of Infectious Diseases Referral and Inappropriate Antibiotic Usage Post-Referral in an Asian Tertiary Hospital

et al. 2019

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Infectious diseases (ID) specialists advise on complicated infections and are advocates for the interventions of antibiotic stewardship programs (ASP). Early referral to ID specialists has been shown to improve patient outcomes; however, not all referrals to ID specialists are made in a timely fashion. A retrospective cross-sectional study of all referrals to ID specialists in a Singaporean tertiary hospital was conducted from January 2016 to January 2018. The following quality indicators were examined: early referral to ID specialists (within 48 h of admission) and ASP intervention for inappropriate antibiotic usage, even after referral to ID specialists. Chi-square was used for univariate analysis and logistic regression for multivariate analysis. A total of 6490 referrals over the 2-year period were analysed; of those, 36.7% (2384/6490) were from surgical disciplines, 47.0% (3050/6490) were from medical disciplines, 14.2% (922/6490) from haematology/oncology and 2.1% (134/6490) were made to the transplant ID service. Haematology/oncology patients and older patients (aged ≥ 60 years) had lower odds of early referral to ID specialists but higher odds of subsequent ASP intervention for inappropriate antibiotic usage, despite prior referral to an ID specialist. Elderly patients and haematology/oncology patients can be referred to ID specialists earlier and their antimicrobial regimens further optimised, perhaps by fostering closer cooperation between ID specialists and primary physicians.

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Section: Discussionmentioning

confidence: 99%

Timeliness of Infectious Diseases Referral and Inappropriate Antibiotic Usage Post-Referral in an Asian Tertiary Hospital

et al. 2019

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Nosocomial Candidiasis: Antifungal Stewardship and the Importance of Rapid Diagnosis

2015

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Candidemia and other forms of candidiasis are associated with considerable excess mortality and costs. Despite the addition of several new antifungal agents with improved spectrum and potency, the frequency of Candida infection and associated mortality have not decreased in the past two decades. The lack of rapid and sensitive diagnostic tests has led to considerable overuse of antifungal agents resulting in increased costs, selection pressure for resistance, unnecessary drug toxicity, and adverse drug interactions. Both the lack of timely diagnostic tests and emergence of antifungal resistance pose considerable problems for antifungal stewardship. Whereas antifungal stewardship with a focus on nosocomial candidiasis should be able to improve the administration of antifungal therapy in terms of drug selection, proper dose and duration, source control and de-escalation therapy, an important parameter, timeliness of antifungal therapy, remains a victim of slow and insensitive diagnostic tests. Fortunately, new proteomic and molecular diagnostic tools are improving the time to species identification and detection. In this review we will describe the potential impact that rapid diagnostic testing and antifungal stewardship can have on the management of nosocomial candidiasis.

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Invasive candidosis: contrasting the perceptions of infectious disease physicians and intensive care physicians

Cited by 2 publications

References 14 publications

Timeliness of Infectious Diseases Referral and Inappropriate Antibiotic Usage Post-Referral in an Asian Tertiary Hospital

Timeliness of Infectious Diseases Referral and Inappropriate Antibiotic Usage Post-Referral in an Asian Tertiary Hospital

Nosocomial Candidiasis: Antifungal Stewardship and the Importance of Rapid Diagnosis

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