부산대학교 도서관

The Candida species are fungi that normally live in areas such as the skin and intestines, but they can also be found in the bloodstream of immunocompromised hosts. Because of the high mortality rate of candidemia, the early diagnosis and appropriate treatment of such infections is important. Since 2015, we have conducted antifungal stewardship conferences aimed at medical institutions in Toyama to promote antifungal stewardship measures. In this study, we investigated background and treatmentrelated factors in 235 cases of candidemia at seven institutions in Toyama from January 1, 2009 to June 30, 2018. We also weighed the effect of each factor before and after the conferences. Candida albicans was the fungus most often isolated at the institutions, and micafungin was the most commonly used first-line antifungal agent. Advanced age (≧65 years), undernourishment, and receipt of total parental nutrition were the primary background factors. After the conference launched, areas such as choice of appropriate antifungal agent and dose, confirmation of negative blood culture, and the number of ophthalmological examinations significantly improved. Problems such as the removal of central venous catheters (recommended within 24 hours) remained, but we expect further improvements from this point on.