Antifungal Utilization for Invasive Candidiasis in 26 United States Children’s Hospitals

T.E. ZAOUTIS, MD, MSCE1, P.A. PRASAD, MPH1, K.H. HEYDON, MS1, T.J. WALSH, MD2

Author address: 

1Children’s Hospital of Philadelphia, Philadelphia, PA, 2National Cancer Institute, Bethesda, MD.

Abstract: 

Background: The most common cause of fungal infection in hospitalized children is Candida. In order to effectively treat these candidal infections, new antifungal therapies have been developed. To date, little has been done to describe antifungal utilization among pediatric patients with invasive candidiasis (IC). Methods: The Pediatric Health Information System (PHIS), a database containing billing information from over 26 free standing children’s hospitals nationwide, was used to describe antifungal prescription among patients with IC between January 1, 2000 and December 31, 2005. Hospitals that did not contribute 2000 data were excluded from analysis. Detailed pharmacy data were abstracted and the usage patterns of amphotericin B (ampho B), fluconazole, voriconazole, itraconazole, caspofungin, and micafungin, were observed for all those patients with an ICD-9-CM code of 112.5 (disseminated candidiasis). It was assumed that a patient had received antifungal therapy if there was at least one billed charge for any of the above drugs within a unique hospitalization. Results: There were a total of 2237 IC cases that received antifungal therapy from 2000 to 2005. Micafungin was not used for any patient with IC. Table 1: Percentage of IC patients receiving therapy. Conclusion: Ampho B deoxycholate use for treatment of IC decreased while lipid formulations of ampho B increased in use. Caspofungin and voriconazole were increasingly being used and fluconazole prescription remained steady.
2006

abstract No: 

571

Full conference title: 

Infectious Diseases Society of America, 44th Annual Meeting
    • IDSA 44th