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Antifungal use in immunocompromised children in Europe: a 12-week multicenter weekly point prevalence survey (CALYPSO)

Lookup NU author(s): Professor Marieke Emonts-le ClercqORCiD, Dr Liz Ghimenton

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).

Abstract

We prospectively analyzed antifungal use in immunocompromised children through a multicenter 12-week weekly point-prevalence survey in 31 hematology-oncology (HO) and hematopoietic stem cell/solid organ transplant (HSCT/SOT) units of 18 hospitals in 11 European countries. All patients hospitalized and receiving systemic antifungals were included. Ward policies, and weekly ward/patient data were collected. All 21 HO and 10 HSCT/SOT units had prophylaxis policies for high-risk patients (27/31 used azoles, 14/31 echinocandins and 15/31 liposomal amphotericin B [LAMB]). Among 572 courses recorded, prophylaxis was indicated in 439/572 (77%) and treatment in 133/572 (62/133 empirical, 43/133 pre-emptive, 28/133 targeted). Among patients receiving prophylaxis, 56% belonged to the non-high-risk group. Most common reasons for empirical, pre-emptive and targeted treatment were antibiotic-resistant febrile neutropenia (52%), abnormalities on chest-CT with/without positive galactomannan (77%) and candidiasis (82%), respectively. Fluconazole and LAMB were the most frequently prescribed agents both for prophylaxis (31%, 21%) and treatment (32%, 23%). Underdosing of micafungin for treatment in 50% of prescriptions and of fluconazole for treatment and prophylaxis in 70% of cases was noticed. In conclusion, most antifungal prescribing was for prophylaxis, with fluconazole being the main antifungal prescribed. Inadequate doses of antifungal prescribing and prophylaxis of non-high-risk patients could be targets for improvement.

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Author(s): Chorafa E, Iosifidis E, Oletto A, Warris A, Castagnola E, Bruggemann R, Groll AH, Lehrnbecher T, Ferreras Antolin L, Mesini A, Abdalla Alkhaaldi A, Baquero-Artigao F, Sirvan Cetin B, Ebrahimi-Fakhari D, Emonts M, Esposito S, Fainardi V, Ghimenton-Walters E, Gijón M, González Guerrero A, Grasa CD, Kairiene I, Kildonaviciute K, MariaKourti M, Manzanares A, Mendoza-Palomar N, Noni M, Papakonstantinou E, Paulus S, Perwein T, Rascon J, Rincón-López E, Soler-Palacin P, Solopova G, Spoulou V, Strenger V, Tedford K, Tzika C, Zsigmond B, Roilides E

Publication type: Article

Publication status: Published

Journal: Journal of Pediatric Hematology/Oncology

Year: 2025

Volume: 47

Issue: 6

Pages: e222-e230

Print publication date: 01/08/2025

Online publication date: 20/06/2025

Acceptance date: 02/06/2025

Date deposited: 09/06/2025

ISSN (print): 1077-4114

ISSN (electronic): 1536-3678

Publisher: Wolters Kluwer Health, Inc.

URL: https://doi.org/10.1097/MPH.0000000000003070

DOI: 10.1097/MPH.0000000000003070

ePrints DOI: 10.57711/2stw-fh81

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