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     Impact of Pharmacists' Intervention on Antifungal Therapy Decisions for Candidemia (Part One)

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    Author
    Chu, Anita
    Corrigan, Jennifer
    Affiliation
    College of Pharmacy, The University of Arizona
    Issue Date
    2010
    Keywords
    Antifungal Therapy
    Candidemia
    Intervention
    MeSH Subjects
    Antifungal Agents
    Candidemia
    Early Medical Intervention
    Advisor
    Matthias, Kathryn
    
    Metadata
    Show full item record
    Rights
    Copyright © is held by the author.
    Collection Information
    This item is part of the Pharmacy Student Research Projects collection, made available by the College of Pharmacy and the University Libraries at the University of Arizona. For more information about items in this collection, please contact Jennifer Martin, Librarian and Clinical Instructor, Pharmacy Practice and Science, jenmartin@email.arizona.edu.
    Publisher
    The University of Arizona.
    Abstract
    OBJECTIVES: The overall objective of this project is to conduct an evaluation of the impact of pharmacists’ early interventions on clinical outcomes in patients with candidemia infections using a new microbiology assay, peptide nucleic acid fluorescence in situ hybridization (PNA FISH). The primary purpose of part one of the project was to evaluate timing of antifungal therapy decisions for candidemia and patient outcomes prior to implementation of the PNA FISH assay. A second part of this project will evaluate patient outcomes and timing of antifungal therapy decisions after implementation of planned pharmacists' early intervention based on candida species determination by the PNA FISH assay. METHODS: In this part one IRB-­‐approved, retrospective study, all patients with a Candida species isolated from blood at a tertiary medical center during a one-­‐year period were reviewed. Subjects were excluded from analyses if discharged alive prior to the final blood culture report for the index Candida species isolated. The time to proper antifungal therapy in relation to timing of blood culture, detection of candida growth, and determination of candida species were evaluated. The second part of this study is IRB-­‐approved and data collection is currently in progress for a second one-­‐year period after implementation of the PNA FISH assay for Candida species. During the second part of this study, designated pharmacists provided antifungal therapy recommendations based on PNA FISH results to each patient's healthcare team. RESULTS: n part one of this study, a total of 61 patients with candidemia were evaluated. The majority of candida infections were caused by either C. albicans (n=24) or C. glabrata (n=11). Prior to implementation of the PNA FISH assay, the mean time to final identification of C. albicans was 82.4 +/-­‐ 19.2 hours while the mean time for C. glabrata was 143 +/-­‐ 39.2 hours (p < 0.0001). The mean time to detection of candida growth, which is approximately the time PNA FISH assay performed in part two of project, was 31.2 +/-­‐ 19.8 hours. Planned data analysis will include comparison of time to appropriate antifungal therapy and clinical patient outcomes between part one and part two patient populations. CONCLUSIONS: The preliminary results of this part 1 of 2 studies provides the baseline data for comparison of antifungal therapy decisions for candidemia pre-­‐ and post-­‐ implementation of pharmacists' intervention based on PNA FISH results.
    Description
    Class of 2012 Abstract
    Collections
    Pharmacy Student Research Projects

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