There are limited reports on the effectiveness of promoting pharmacist-led management of candidemia in tertiary care hospitals without a full-time infectious disease specialist. We aimed to assess the effectiveness of promoting pharmacist-led management of candidemia in a tertiary care hospital without a full-time infectious disease specialist and to determine the type of support provided by pharmacists in the antimicrobial stewardship team. This retrospective cohort study evaluated patients with Candida spp. detected in blood cultures between April 2013 and March 2024 at our hospital. To compare the effect of bundled intervention on patients with candidemia, patients enrolled during the periods from April 2013 to March 2018 and April 2018 to March 2024 were classified in the pre- and post-antimicrobial stewardship team pharmacist intervention groups, respectively. There were no significant differences in the baseline clinical characteristics or Candida spp. distribution between the two groups. Compliance to the candidemia treatment bundle significantly improved in the post-antimicrobial stewardship team pharmacist intervention group (4.5% vs 39.6%); however, there was no difference between the two groups in 30-day mortality. The antimicrobial stewardship team pharmacist primarily contributed by recommending treatment initiation, drug selection, and checking for bundle compliance. Pharmacist-led management of candidemia did not improve outcomes for patients with candidemia in a tertiary care hospital with no full-time infectious disease specialist. However, this management may have helped improve the quality of antifungal therapy in terms of drug selection, dosing, and drug interactions, thus contributing to improved candidemia treatment bundle compliance.
Kinoshita et al. (Fri,) studied this question.