Study of Prescription-Indication of Outpatient Systemic Anti-Fungals in a Colombian Population. A Cross-Sectional Study

The inappropriate use of antifungals is associated with greater antimicrobial resistance, costs, adverse events, and worse clinical outcomes. The aim of this study was to determine prescription patterns and approved and unapproved indications for systemic antifungals in a group of patients in Colomb...

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Bibliographic Details
Published in:Antibiotics (Basel) 2022-12, Vol.11 (12), p.1805
Main Authors: Valladales-Restrepo, Luis Fernando, Ospina-Cano, Juan Alberto, Aristizábal-Carmona, Brayan Stiven, López-Caicedo, Diana Fiorella, Toro-Londoño, Melissa, Gaviria-Mendoza, Andrés, Machado-Duque, Manuel Enrique, Machado-Alba, Jorge Enrique
Format: Article
Language:English
Subjects:
Analysis
Antifungal agents
Antimicrobial agents
Antimicrobial resistance
Bivariate analysis
Chronic obstructive pulmonary disease
Colombia
Cross-sectional studies
Diabetes
Diabetes mellitus
drug prescriptions
Drug resistance
Drug resistance in microorganisms
Drug use
Fluconazole
Fungal infections
Fungicides
Health insurance
HIV
Human immunodeficiency virus
inappropriate prescribing
Ketoconazole
Lung diseases
Mycoses
Mycosis
Obstructive lung disease
pharmacoepidemiology
Pharmacy
Population studies
Vaginitis
Vulvovaginitis
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Summary:The inappropriate use of antifungals is associated with greater antimicrobial resistance, costs, adverse events, and worse clinical outcomes. The aim of this study was to determine prescription patterns and approved and unapproved indications for systemic antifungals in a group of patients in Colombia. This was a cross-sectional study on indications for the use of systemic antifungals in outpatients from a drug dispensing database of approximately 9.2 million people affiliated with the Colombian Health System. Sociodemographic, pharmacological, and clinical variables were considered. Descriptive, bivariate, and multivariate analyses were performed. A total of 74,603 patients with antifungal prescriptions were identified; they had a median age of 36.0 years (interquartile range: 22.0−53.0 years), and 67.3% of patients were women. Fluconazole (66.5%) was the most prescribed antifungal for indications such as vaginitis, vulvitis, and vulvovaginitis (35.0%). A total of 29.3% of the prescriptions were used in unapproved indications. A total of 96.3% of ketoconazole users used the medication in unapproved indications. Men (OR: 1.91; CI95%: 1.79−2.04),
ISSN:2079-6382
2079-6382
DOI:10.3390/antibiotics11121805