Article
作者: Ferreras Antolin, Laura ; Vergadi, Eleni ; Romani, Lorenza ; Warris, Adilia ; Emonts, Marieke ; Jõgi, Piia ; Rincón-López, Elena ; Bruggemann, Roger ; Kildonaviciute, Kornelija ; Esposito, Susanna ; Cetin, Benhur Sirvan ; Sánchez, Laura ; Leibold-Aguinarte, Alessa ; Castagnola, Elio ; Oletto, Andrea ; Perrone, Serafina ; Mesini, Alessio ; Grasa, Carlos ; Mendoza-Palomar, Natalia ; Chorafa, Elisavet ; Paulus, Stéphane ; Ghimenton-Walters, Elisabetta ; Gkentzi, Despoina ; Lehrnbecher, Thomas ; Noni, Maria ; Manzanares, Angela ; Strenger, Volker ; Agakidou, Eleni ; Villaverde, Serena ; De Luca, Maia ; Metsvaht, Tuuli ; Vuerich, Marco ; Zamora-Flores, Elena ; Roilides, Emmanuel ; Hatzidaki, Eleftheria ; Kontou, Angeliki ; Controzzi, Tiziana ; Iosifidis, Elias ; Spoulou, Vana ; Groll, Andreas H. ; Fernàndez-Polo, Aurora ; Dimitriou, Gabriel
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.