Antifungal Drug Usage in European Neonatal Units: A Multicenter Weekly Point Prevalence Study.

Journal

The Pediatric infectious disease journal

ISSN: 1532-0987

Titre abrégé: Pediatr Infect Dis J

Pays: United States

ID NLM: 8701858

Informations de publication

Date de publication:
25 Jun 2024

Historique:

medline: 25 6 2024

pubmed: 25 6 2024

entrez: 25 6 2024

Statut: aheadofprint

Résumé

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. 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. 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. Antifungal usage in European NUs is driven by prophylaxis and empirical treatment with fluconazole being the most prescribed agent for both indications.

Sections du résumé

BACKGROUND BACKGROUND

METHODS 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 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 CONCLUSIONS

Antifungal usage in European NUs is driven by prophylaxis and empirical treatment with fluconazole being the most prescribed agent for both indications.

Identifiants

DOI: 10.1097/INF.0000000000004445 PMID: 38917027

pubmed: 38917027

doi: 10.1097/INF.0000000000004445

pii: 00006454-990000000-00920

doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

Informations de copyright

Déclaration de conflit d'intérêts

E.C.: Speaker at sponsored symposia for Pfizer and F2G. C.G. is funded by the Spanish Ministry of Science and Innovation—Instituto de Salud Carlos III and Fondos FEDER (Contrato Juan Rodés JR22/00044). A.H.G. has received grants from Gilead, Merck, Sharp & Dohme and Pfizer and has served as a consultant to Amplyx, Astellas, Basilea, F2G, Gilead. Merck, Sharp & Dohme, Pfizer, Scynexis and Mundipharma. T.L. has received a grant from Gilead Sciences, has served as a consultant to Gilead Sciences, Merck/MSD, Pfizer, Astellas, AstraZeneca, Recordati and Roche and served at the speaker´s bureau of Gilead Sciences, Merck/MSD, Astellas, Pfizer and GSK and Recordati. E.R. has received research grants from Merck, Abvie, Shionogi, Cidara and Pfizer Inc. to his institution and is a scientific advisor and member of the speaker bureaux for Gilead, Merck, Shionogi, Mundipharma and Pfizer Inc. For the remaining authors, there are no conflicts of interest to disclose.

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