A Point Prevalence Survey (PPS) of Neonatal and Paediatric Antifungal Use in Europe

Ref ID: 18721

Author:

C. Bertaina, MD – Registrar1, K. Doerholt, MD – consultant 2, J. Bielicki, MD – research fellow 3, A. Versporten, MD – Consultant 4, H. Goossens, MD – Professor 4, I. Lutsar, MD – Consultant 5, M. Sharland, MD – Professor 2,3;

Author address:

1Regina Margherita Hosp., Turin, Italy, 2St George’s Hosp. NHS Trust, London, United Kingdom, 3St George’s Univ., London, United Kingdom, 4Univ. of Antwerp-Campus Drie Eiken, Antwerp, Belgium, 5Univ. of Tartu, Tartu, Estonia.

Full conference title:

52nd Annual ICAAC

Date: 9 September 2014

Abstract:

Background: Invasive fungal infections are associated with significant morbidity and mortality in hospitalised neonates and children. There is limited evidence based guidance for empiric antifungal therapy. We aimed to describe the patterns of antifungal use in European hospitals participating in the Point Prevalence Survey (PPS) of the Antimicrobial Resistance and Prescribing in European Children (ARPEC) project. Methods: A one day PPS was completed between 19th-30th September 2011 in 36 hospitals across 13 European countries. Data were collected using standardized collection forms with online data-entry using the ARPEC-WEBPPS program. All admitted children on the day of the survey receiving antimicrobial treatment were included. Results: Data on 266 neonates and 955 children were obtained. Antifungal prescriptions comprised 24 (5%) of 474 and 112 (7%) of 1614 of the total antimicrobial neonatal and paediatric prescriptions respectively. 20 (82%) of the 24 neonatal antifungal prescriptions occurred in ELBW (<1000g) neonates. The only prescribed antifungals in neonates were fluconazole 16 (67%), amphotericin B 7 (29%) and Flucytosine 1 (4%) with 54% of prescriptions reported as prophylaxis. Paediatric patients had a median age of 5 years (IQR 2; 12), 90 (88%) of 102 receiving antifungals had an underlying haemato-oncology diagnosis. The most used antifungals in paediatrics were amphotericin formulations in 46 (41%), fluconazole in 42 (38%) and caspofungin in 8 (7%) children, with prophylactic prescriptions in 63%. Fluconazole was used mainly once daily, with a median of 5 mg/kg (range 1.9-12) for 19 children receiving treatment and 4.2 mg/kg (range 2.6-9.5) for 22 children on prophylaxis. Conclusions: As expected the use of antifungals in neonates was mainly in ELBW and in children for haemato-oncology, with older generation antifungals still predominant in both settings. The wide range of dosing used identifies future options for improving targeted therapy

Abstract Number: G3-1559

Conference Poster: y

Conference Year: 2012

Link to conference website: NULL

New link: NULL

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