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Chorafa, E; Iosifidis, E; Oletto, A; Warris, A; Castagnola, E; Bruggemann, R; Groll, AH; Lehrnbecher, T; Ferreras, Antolin, L; Mesini, A; Agakidou, E; Controzzi, T; De, Luca, M; Dimitriou, G; Emonts, M; Esposito, S; Fernàndez-Polo, A; Ghimenton-Walters, E; Gkentzi, D; Grasa, C; Hatzidaki, E; Jõgi, P; Kildonaviciute, K; Kontou, A; Leibold-Aguinarte, A; Manzanares, A; Mendoza-Palomar, N; Metsvaht, T; Noni, M; Paulus, S; Perrone, S; Rincón-López, E; Romani, L; Sánchez, L; Cetin, BS; Spoulou, V; Strenger, V; Vergadi, E; Villaverde, S; Vuerich, M; Zamora-Flores, E; Roilides, E.
Antifungal Drug Usage in European Neonatal Units: A Multicenter Weekly Point Prevalence Study.
Pediatr Infect Dis J. 2024; 43(11):1047-1048 Doi: 10.1097/INF.0000000000004445
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Strenger Volker

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Abstract:

BACKGROUND: Data on antifungal prescribing in neonatal patients are limited to either single-center or single-country studies or to 1-day recording. Therefore, we assessed antifungal longitudinal usage in neonatal units (NUs) within Europe. METHODS: CALYPSO, a prospective weekly point prevalence study on antifungal drug usage in NUs in 18 hospitals (8 European countries), was conducted in 2020 during a 12-week period. All patients receiving systemic antifungals were included. Ward demographics were collected at the beginning; ward and patient data including indication, risk factors and antifungal regimen were weekly collected prospectively. RESULTS: Among 27 participating NUs, 15 (56%) practiced antifungal prophylaxis for neonates with birth weight <1000 g or <1500 g and additional risk factors. In total, 174 patients received antifungals with a median frequency per week of 10.5% ranging from 6.9% to 12.6%. Indication for antifungal prescribing was prophylaxis in 135/174 (78%) courses and treatment in 22% [39 courses (69% empirical, 10% preemptive, 21% targeted)]. Fluconazole was the most frequent systemic agent used both for prophylaxis (133/135) and treatment (15/39, 39%). Among neonates receiving prophylaxis, the most common risk factors were prematurity (119/135, 88%), mechanical ventilation (109/135, 81%) and central vascular catheters (89/135, 66%). However, gestational age <28 weeks was only recorded in 55/135 (41%) courses and birth weight <1000 g in 48/135 (35%). Most common reason for empirical treatment was late-onset sepsis; all 8 targeted courses were prescribed for invasive candidiasis. CONCLUSION: Antifungal usage in European NUs is driven by prophylaxis and empirical treatment with fluconazole being the most prescribed agent for both indications.

Find related publications in this database (using NLM MeSH Indexing)

Female - administration & dosage

Humans - administration & dosage

Infant, Newborn - administration & dosage

Male - administration & dosage

Antifungal Agents - therapeutic use, administration & dosage

Drug Utilization - statistics & numerical data

Europe - epidemiology

Fluconazole - therapeutic use

Intensive Care Units, Neonatal - statistics & numerical data

Prevalence - administration & dosage

Prospective Studies - administration & dosage

Risk Factors - administration & dosage

Find related publications in this database (Keywords)

antifungal agents

antifungal use

neonates

antifungal stewardship

antifungal prescriptions

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