PHARMACOEPIDEMIOLOGICAL EVALUATION OF ANTIFUNGAL DRUG THERAPY USED IN HOSPITAL UNIVERSITI SAINS MALAYSIA (HUSM)

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Date
2010-12
Authors
MOHAMMED, HAMID MAHMOUD NASRELDEEN
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Abstract
Today, managing fungal infection is one of the challenges doctors have to face worldwide. Fungal infection is considered as one of the main causes of morbidity and mortality among patients, especially those who are severely immunocompromised. In the current work, retrospective study was undertaken in order to determine the epidemiology and management of fun gal infection among both outpatients and hospitalized pati ents at Universiti Sains Malaysia Hospital (HUSM). The data were divided into outpatients and hospitalized patients. Data of hospitalized patients were collected from the medical record . The total numbers of patients with confirmed cases of fungal infecti on based on laboratory investigati on were 290 patients. Majority of study subjects with fungal infections are Malay. The age group 18-27 years had high frequency accounting to 31 %. Females (212, 73.1 %) were diagnosed more for fungal infections than males (78, 26.9%) probably due to vaginal candidiasis. The obstetrics ward recorded more fungal infected patients ( 130, 44.8%) than other wards. Half of the patients (145, 50%) were hospitalized betwew 1-4 days. Death, among the fungal infected patients of this study was 27 (9 .3%). Diabetes mellitus (47, 18.6%), seems to be the most frequently co-morbidity disease. Antibiotic usage was the common ri sk factor associated with fungal infection accounting for 199 (68.6%) patients. Candida albicans is the most frequent identified fungi (169, 58%). Among the patients, 81 (27.9%) were treated with antifungal drug therapy. Fluconazole was the most common drug used to treat the hospitalized fungal infected patients. Data of outpatients was collected retrospectively from the medical prescriptions. There were 1090 outpatients treated with antifungal drug therapy during the study period from 1 Jan. 2005 to 30 of June 2005. Females (677, 62.1 %) were the majority of patients among the outpatient. Malay was accounted as the most among the ethnic groups (979, 89.8%); followed Chinese (94, 8.6%), Indian (14, 1.3%). Family clinic has received most patients. Skin (927, 85%) was the most affected system compared to other body systems. Miconazole (818, 75%), was most frequently given to the patients. About 97.7% of the prescribers were medical officers according to the prescription record. The general features of fungal infection in this setting were similar to studies conducted worldwide. In conclusion, the current study has identified the general pattern of fungal infection and the use of antifungal medication given to patients admitted to the medical wards and to those who came to the outpatients' clinics of the USM Hospital.
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PHARMACOEPIDEMIOLOGICAL , DRUG THERAPY
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