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Characteristics of antifungal utilization for hospitalized children in the United States.


ABSTRACT:

Objective

To characterize antifungal prescribing patterns, including the indication for antifungal use, in hospitalized children across the United States.

Design

We analyzed antifungal prescribing data from 32 hospitals that participated in the SHARPS Antibiotic Resistance, Prescribing, and Efficacy among Children (SHARPEC) study, a cross-sectional point-prevalence survey conducted between June 2016 and December 2017.

Methods

Inpatients aged <18 years with an active systemic antifungal order were included in the analysis. We classified antifungal prescribing by indication (ie, prophylaxis, empiric, targeted), and we compared the proportion of patients in each category based on patient and antifungal characteristics.

Results

Among 34,927 surveyed patients, 2,095 (6%) received at least 1 systemic antifungal and there were 2,207 antifungal prescriptions. Most patients had an underlying oncology or bone marrow transplant diagnosis (57%) or were premature (13%). The most prescribed antifungal was fluconazole (48%) and the most common indication for antifungal use was prophylaxis (64%). Of 2,095 patients receiving antifungals, 79 (4%) were prescribed >1 antifungal, most often as targeted therapy (48%). The antifungal prescribing rate ranged from 13.6 to 131.2 antifungals per 1,000 patients across hospitals (P < .001).

Conclusions

Most antifungal use in hospitalized children was for prophylaxis, and the rate of antifungal prescribing varied significantly across hospitals. Potential targets for antifungal stewardship efforts include high-risk, high-utilization populations, such as oncology and bone marrow transplant patients, and specific patterns of utilization, including prophylactic and combination antifungal therapy.

SUBMITTER: Eguiguren L 

PROVIDER: S-EPMC9726632 | biostudies-literature | 2022

REPOSITORIES: biostudies-literature

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Publications

Characteristics of antifungal utilization for hospitalized children in the United States.

Eguiguren Lourdes L   Lee Brian R BR   Newland Jason G JG   Kronman Matthew P MP   Hersh Adam L AL   Gerber Jeffrey S JS   Lee Grace M GM   Schwenk Hayden T HT  

Antimicrobial stewardship & healthcare epidemiology : ASHE 20221202 1


<h4>Objective</h4>To characterize antifungal prescribing patterns, including the indication for antifungal use, in hospitalized children across the United States.<h4>Design</h4>We analyzed antifungal prescribing data from 32 hospitals that participated in the SHARPS Antibiotic Resistance, Prescribing, and Efficacy among Children (SHARPEC) study, a cross-sectional point-prevalence survey conducted between June 2016 and December 2017.<h4>Methods</h4>Inpatients aged <18 years with an active systemi  ...[more]

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