Utility of 1,3 β-d-Glucan Assay for Guidance in Antifungal Stewardship Programs for Oncologic Patients and Solid Organ Transplant Recipients

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Machado, Marina and Chamorro de Vega, Esther and Martínez Jiménez, María del Carmen and Rodríguez González, Carmen Guadalupe and Vena, Antonio and Navarro, Raquel and Zamora Cintas, María Isabel and Agnelli, Caroline and Olmedo, María and Galar, Alicia and Guinea, Jesús and Fernández Cruz, Ana and Alonso Fernández, Roberto and Bouza, Emilio and Muñoz García, Patricia and Valerio Minero, Maricela (2021) Utility of 1,3 β-d-Glucan Assay for Guidance in Antifungal Stewardship Programs for Oncologic Patients and Solid Organ Transplant Recipients. Journal of Fungi, 7 (1). p. 59. ISSN 2309-608X

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Official URL: https://doi.org/10.3390/jof7010059




Abstract

The implementation of 1,3 β-d-glucan (BDG) has been proposed as a diagnostic tool in antifungal stewardship programs (ASPs). We aimed to analyze the influence of serum BDG in an ASP for oncologic patients and solid organ transplant (SOT) recipients. We conducted a pre–post study. In the initial period (PRE), the ASP was based on bedside advice, and this was complemented with BDG in the post-period (POST). Performance parameters of the BDG assay were determined. Antifungal (AF) use adequacy was evaluated using a point score. Clinical outcomes and AF costs were also compared before and after the intervention. Overall, 85 patients were included in the PRE-period and 112 in the POST-period. Probable or proven fungal infections were similar in both groups (54.1% vs. 57.1%; p = 0.67). The determination of BDG contributed to improved management in 75 of 112 patients (66.9%). The AF adequacy score improved in the POST-period (mean 7.75 vs. 9.29; p < 0.001). Median days of empiric AF treatment was reduced in the POST-period (9 vs. 5 days, p = 0.04). All-cause mortality (44.7% vs. 34.8%; p = 0.16) was similar in both periods. The cost of AF treatments was reduced in the POST-period with a difference of 779.6 €/patient. Our data suggest that the use of BDG was a cost-effective strategy that contributed to safely improving the results of an ASP for SOT and oncologic patients.


Item Type:Article
Uncontrolled Keywords:antifungal stewardship; antifungals; biomarkers; invasive fungal infections; solid organ transplant; oncologic patients; 1,3 β-d-glucan
Subjects:Medical sciences > Medicine > Surgery
Medical sciences > Medicine > Oncology
ID Code:72331
Deposited On:30 May 2022 14:12
Last Modified:30 May 2022 14:29

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