Pharmacist-Led Team Improves Candidemia Outcomes

A pharmacist-led infectious disease support team (IDST) significantly improved adherence to evidence-based candidemia treatment recommendations and was associated with lower 28-day mortality, according to a new study published in the European Journal of Clinical Microbiology & Infectious Diseases.

Candidemia, a bloodstream infection caused by Candida species, is one of the most serious invasive fungal infections encountered in hospitals. Despite advances in antifungal therapy, mortality remains high, making timely diagnosis and adherence to treatment guidelines critical for improving patient outcomes. While antimicrobial stewardship programmes are well established for bacterial infections, evidence supporting pharmacist-led multidisciplinary management of candidemia has been limited.

Study Evaluated Pharmacist-Led Support

Researchers conducted a retrospective cohort study at Yamanashi Prefectural Central Hospital in Japan, analysing outcomes among hospitalised patients diagnosed with candidemia between April 2018 and September 2025.

The study included 89 patients with a median age of 74 years who had at least one positive blood culture for Candida species. Patients who died within 48 hours of diagnosis or whose 28-day survival status was unavailable were excluded.

The investigators compared outcomes before and after the implementation of a pharmacist-led infectious disease support team, assessing adherence to an eight-item candidemia treatment bundle alongside clinical outcomes including mortality and microbiological clearance.

Better Adherence to Treatment Guidelines

Overall, 61.8% of patients achieved adherence to at least 75% of the candidemia treatment bundle.

Patients managed with support from the pharmacist-led IDST demonstrated significantly higher adherence to multiple components of the treatment bundle compared with those receiving standard care. The team helped improve implementation of recommended management practices, which include timely antifungal therapy, appropriate follow-up investigations, and source control measures.

The authors suggest that closer multidisciplinary oversight may have contributed to more consistent delivery of guideline-based care.

Lower Mortality and Higher Eradication Rates

Clinical outcomes also improved following implementation of the pharmacist-led service.

Twenty-eight-day mortality was significantly lower in the IDST group than in patients managed without specialist support, with mortality rates of 29.2% compared with 56.1%.

Patients receiving IDST input also achieved significantly higher microbiological eradication rates, with successful clearance of Candida documented in 87.5% of cases compared with 61.0% in the non-IDST group.

Multivariable analysis further demonstrated that pharmacist-led intervention was independently associated with a reduced risk of death within 28 days, suggesting that the observed survival benefit persisted after adjustment for other clinical factors.

Expanding the Role of Pharmacists in Infectious Diseases

The authors conclude that pharmacist-led infectious disease support can improve both adherence to evidence-based candidemia management and patient outcomes.

Although the findings are based on a single-centre retrospective study, they add to growing evidence supporting expanded roles for clinical pharmacists within multidisciplinary infectious disease teams. The researchers suggest that incorporating pharmacist-led support into antifungal stewardship programmes may help standardise candidemia management, improve microbiological clearance, and reduce mortality among hospitalised patients.

Further multicentre prospective studies will be needed to confirm these findings and determine whether similar benefits can be achieved across different healthcare settings.