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Chorafa, E; Iosifidis, E; Oletto, A; Warris, A; Castagnola, E; Bruggemann, R; Groll, AH; Lehrnbecher, T; Antolin, LF; Mesini, A; Alkhaaldi, AA; Baquero-Artigao, F; Cetin, BS; Ebrahimi-Fakhari, D; Emonts, M; Esposito, S; Fainardi, V; Ghimenton-Walters, E; Gijón, M; Guerrero, AG; Grasa, CD; Kairiene, I; Kildonaviciute, K; Kourti, 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.
Antifungal Use in Immunocompromised Children in Europe: A 12-Week Multicenter Weekly Point Prevalence Survey (CALYPSO)
J PEDIAT HEMATOL ONC. 2025; 47(6): e222-e230. Doi: 10.1097/MPH.0000000000003070
Web of Science PubMed FullText FullText_MUG

Co-authors Med Uni Graz: Perwein Thomas; Strenger Volker
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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.
Find related publications in this database (Keywords): antifungal agents; antifungal use; immunocompromised patients; antifungal stewardship; antifungal prescriptions