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.