Antifungal prescribing pattern and attitude toward the treatment of candidiasis among medical doctors in the Buea Health District Southwest Region, Cameroon

Candidiasis are infections caused by Candida species. It is a significant public health concern worldwide. Treatment of candidiasis rely on antifungal medications, which are often prescribed empirically. However, the increasing prevalence of antifungal resistance and the lack of standardised treatment guidelines have raised concerns about the suitability of current antifungal prescription. This study aimed to determine the pattern of antifungal prescription and attitude toward the treatment of candidiasis among medical professionals in the Buea Health district Southwest region. A structured questionnaire was developed based on the literature and pre-tested before being distributed to medical doctors from various health facilities in the Buea Health District. Antifungal prescription data were collected from regional hospital medical records booklets using an extraction form. Laboratory results from patients at Buea Regional Hospital were also analysed to identify the main Candida species. SPSS (Statistical package for Social Sciences) version 25.0 was used for descriptive analysis. A total of 114 participants were recruited. First-line treatments for candidiasis by doctors revealed the following commonly prescribed antifungal agents in decreasing order: for uncomplicated vulvovaginal candidiasis, fluconazole 49(43.0%), nystatin 19(16.7%) and miconazole 7(6.1%); for oral thrush, fluconazole 59(51.8%) and nystatin 43(37.7%); for skin candidiasis, miconazole 38(33.3%) and ketoconazole 32(28.1%); and for esophageal candidiasis, fluconazole (63.2%). The duration of treatment varied, with VVC typically prescribed for 3–7 days 63(55.3%), oral thrush for 7–14 days 85(74.6%), cutaneous candidiasis for more than 14 days 62(54.4%) and esophageal candidiasis for 14–21 days 48(42.1%). In candidemia, combination therapy was preferred for both nonneutropenic 38(33.3%) and neutropenic patients 48(42.1%), with treatment durations of 10–14 days 52(45.6%) for nonneutropenic and individualised durations for neutropenic patients. The physicians understood the symptoms as well as various diagnostic methods with various forms of candidiasis, although some gaps about specific treatment protocols and emerging Candida species were identified. The major Candida species isolated from patients attending the Buea Regional Hospital was Candida albicans .