Utilization of fluconazole in an intensive care unit at a university hospital in Brazil

Background Fungi have been developing resistance and merit greater attention because these microorganisms are among the major causes of hospital infection. Objective The aim of the present study was to characterize the pattern of fluconazole use in an adult intensive care unit. Setting The setting was an intensive care unit at a university hospital in Brazil. Method An observational retrospective study was performed between 2007 and 2010. The use of antifungal drugs was calculated as the defined daily dose per 1,000 patient-days. The pattern of fluconazole use was determined by analyzing patient charts. Results Fluconazole accounted an average of 66.6 % of the antifungal agents prescribed. All of the patients exhibited important risk factors for the development of fungal infection. Treatment was empirical in 45.2 % of the cases and therapeutic in 54.8 % of the cases. The dose interval was inadequate in 51.1 % of the treatments. Fluconazole at doses ≥400 mg/day was related to a greater likelihood of survival. C. albicans was the most prevalent species (31.3 %). Urine was the biological material with the greatest number of positive mycological exams (71.9 %). Conclusion This study found a high utilization of fluconazole and, in most cases, its administration at intervals that were different from the recommended intervals.