Utility of 1,3 β-d-Glucan Assay for Guidance in Antifungal Stewardship Programs for Oncologic Patients and Solid Organ Transplant Recipients

Machado, Marina and Chamorro de Vega, Esther and Martínez-Jiménez, María del Carmen and Rodríguez-González, Carmen Guadalupe and Vena, Antonio and Navarro, Raquel and Zamora-Cintas, María Isabel and Agnelli, Caroline and Olmedo, María and Galar, Alicia and Guinea, Jesús and Fernández-Cruz, Ana and Alonso, Roberto and Bouza, Emilio and Muñoz, Patricia and Valerio, Maricela (2021) Utility of 1,3 β-d-Glucan Assay for Guidance in Antifungal Stewardship Programs for Oncologic Patients and Solid Organ Transplant Recipients. Journal of Fungi, 7 (1). p. 59. ISSN 2309-608X

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Abstract

The implementation of 1,3 β-d-glucan (BDG) has been proposed as a diagnostic tool in antifungal stewardship programs (ASPs). We aimed to analyze the influence of serum BDG in an ASP for oncologic patients and solid organ transplant (SOT) recipients. We conducted a pre–post study. In the initial period (PRE), the ASP was based on bedside advice, and this was complemented with BDG in the post-period (POST). Performance parameters of the BDG assay were determined. Antifungal (AF) use adequacy was evaluated using a point score. Clinical outcomes and AF costs were also compared before and after the intervention. Overall, 85 patients were included in the PRE-period and 112 in the POST-period. Probable or proven fungal infections were similar in both groups (54.1% vs. 57.1%; p = 0.67). The determination of BDG contributed to improved management in 75 of 112 patients (66.9%). The AF adequacy score improved in the POST-period (mean 7.75 vs. 9.29; p < 0.001). Median days of empiric AF treatment was reduced in the POST-period (9 vs. 5 days, p = 0.04). All-cause mortality (44.7% vs. 34.8%; p = 0.16) was similar in both periods. The cost of AF treatments was reduced in the POST-period with a difference of 779.6 €/patient. Our data suggest that the use of BDG was a cost-effective strategy that contributed to safely improving the results of an ASP for SOT and oncologic patients.

Item Type: Article
Uncontrolled Keywords: antifungal stewardship; antifungals; biomarkers; invasive fungal infections; solid organ transplant; oncologic patients; 1,3 β-d-glucan
Subjects: STM Repository > Biological Science
Depositing User: Managing Editor
Date Deposited: 30 Mar 2024 03:51
Last Modified: 30 Mar 2024 03:51
URI: http://classical.goforpromo.com/id/eprint/1299

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