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Lookup NU author(s): Professor Marieke Emonts-le ClercqORCiD
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© 2025 The Author(s). Published by Oxford University Press on behalf of the Pediatric Infectious Diseases Society. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site - for further information please contact journals.permissions@oup.com.Background Critically ill pediatric patients admitted to the pediatric intensive care unit (PICU) are highly vulnerable to infections, including invasive fungal diseases and antifungal agents are frequently prescribed. Little is known about antifungal usage in PICUs across Europe. Methods A multinational 3-month weekly point-prevalence study for measuring antifungal drug use was organized. Eigtheen PICUs (16 hospitals) in 10 countries in the European region participated. All patients hospitalized in the participating PICUs and receiving systemic antifungals were included. Information about ward demographics was collected once; weekly ward and patient data were collected prospectively for the 12-week study period and entered in REDCap database. Results Among 18 PICUs, 8 (44%) followed prophylactic practices for targeted group of patients, 7/18 (39%) had an antifungal stewardship program and the majority (16/18, 89%) had the capacity of biomarker utilization (16/16 galactomannan, 13/16 beta-D-glucan, and 9/16 pan-fungal PCR). One hundred one courses in equal number of patients were recorded; 14 for patients aged <3 month, 87 for patients ≥3 month. Malignancy was the most common underlying condition among patients aged ≥3 month (29%) followed by surgery/trauma (25%), whereas all patients <3 month had undergone a recent surgery. Indication for antifungal prescribing was prophylaxis in 38% and treatment in 62% [empirical (57%), preemptive (13%), and targeted (30%)]. Fluconazole was the most common agent both for prophylaxis and treatment, whereas liposomal amphotericin B was the most frequent agent for targeted treatment. The majority (63%) of patients on prophylaxis were oncology or transplant patients. Common reasons for empirical and targeted treatment were persistent fever/other signs of infections in high-risk patients (61%) and Candida infections (100%), respectively. For targeted treatment, the most frequent pathogens were Candida albicans (37%) and Candida parapsilosis (32%). Conclusions Most antifungal prescriptions across European PICUs were for treatment. Fluconazole was the most frequently prescribed antifungal. These surveillance data can guide antifungal stewardship strategies in PICUs.
Author(s): Chorafa E, Iosifidis E, Alkhaaldi AA, Arias A, Cetin BS, De Luca M, Emonts M, Ferreras-Antolin L, Ghimenton-Walters E, Grasa CD, Groll AH, Herrera-Castillo L, Lehrnbecher T, Manzanares A, Masjosthusmann K, Melendo S, Mendoza-Palomar N, Paulus S, Rincon-Lopez E, Romani L, Sdougka M, Solopova G, Strenger V, Tedford K, Tzika C, Warris A, Zsigmond B, Roilides E
Publication type: Article
Publication status: Published
Journal: Journal of the Pediatric Infectious Diseases Society
Year: 2025
Volume: 14
Issue: 10
Print publication date: 01/10/2025
Online publication date: 10/09/2025
Acceptance date: 08/09/2025
ISSN (print): 2048-7193
ISSN (electronic): 2048-7207
Publisher: Oxford University Press
URL: https://doi.org/10.1093/jpids/piaf081
DOI: 10.1093/jpids/piaf081
PubMed id: 40928154
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