AN AUDIT OF THE USE OF ANTIFUNGAL AGENTS

A three month prospective audit of systemic antifungal therapy was und ertaken in a university hospital in the United Kingdom to determine th e patterns of usage of systemic antifungal drugs. The case notes of al l patients receiving systemic antifungal agents were reviewed daily an d the appropriateness of therapy was determined according to standards in the authoritative literature. One hundred and fifteen courses of t reatment with antifungal agents for 1481 days were administered to 74 patients. When a patient had received more than one course of antifung als, both the individual courses and the combination of courses, i.e. a regimen, were judged. Antifungal agents were given as an empirical t herapy or as prophylaxis in 68% of the courses, with fluconazole and a mphotericin B desoxycholate being the agents most frequently used. The rapy was considered unconventional in 26.9% of the courses and 40.5% o f the regimens, mainly because either the indication or the duration o f treatment did not conform to conventional practice. Improvement in p rescribing practices and standards for ongoing audit can only be achie ved if a consensus can be reached on how these agents can be used appr opriately.