Ferreras-Antolín, L;
Irwin, A;
Atra, A;
Dermirjian, A;
Drysdale, SB;
Emonts, M;
McMaster, P;
Paulus, S;
Patel, S;
Kinsey, S;
et al.
Ferreras-Antolín, L; Irwin, A; Atra, A; Dermirjian, A; Drysdale, SB; Emonts, M; McMaster, P; Paulus, S; Patel, S; Kinsey, S; Vergnano, S; Whittaker, E; Warris, A
(2019)
Neonatal Antifungal Consumption Is Dominated by Prophylactic Use; Outcomes From The Pediatric Antifungal Stewardship: Optimizing Antifungal Prescription Study.
Pediatr Infect Dis J, 38 (12).
pp. 1219-1223.
ISSN 1532-0987
https://doi.org/10.1097/INF.0000000000002463
SGUL Authors: Sharland, Michael Roy Drysdale, Simon Bruce
![[img]](https://openaccess.sgul.ac.uk/111288/1.hassmallThumbnailVersion/Neonatal%20Antifungal%20Consumption%20Is%20Dominated%20by%20Prophylactic%20Use%3B%20Outcomes%20From%20The%20Pediatric%20Antifungal%20Stewardship%20Optimizing%20Antifungal%20Prescription%20Study.pdf) ![](https://openaccess.sgul.ac.uk/111288/1.haspreviewThumbnailVersion/Neonatal%20Antifungal%20Consumption%20Is%20Dominated%20by%20Prophylactic%20Use%3B%20Outcomes%20From%20The%20Pediatric%20Antifungal%20Stewardship%20Optimizing%20Antifungal%20Prescription%20Study.pdf) Preview |
|
PDF
Accepted Version
Available under License ["licenses_description_publisher" not defined].
Download (776kB)
| Preview
|
Abstract
BACKGROUND: Diagnostic challenges combined with the vulnerability of neonates to develop invasive candidiasis (IC) may lead to antifungal administration in the absence of IC. A modified point-prevalence study was performed to obtain an improved insight and understanding of antifungal prescribing in this specific patient population. METHODS: Neonates and infants ≤90 days of age receiving systemic antifungals from 12 centers in England were included. Data were collected prospectively during 26 consecutive weeks and entered into an online REDCap database. RESULTS: Two hundred eighty neonates and infants were included, the majority ≤1 month of age (68.2%). Prematurity was the commonest underlying condition (68.9%). Antifungals were prescribed for prophylactic reason in 79.6%; of those, 64.6% and 76.3% were extreme low birth weight infants and prematurely born neonates, respectively. Additional risk factors were present in almost all patients, but only 44.7% had ≥3 risk factors rendering them more susceptible to develop IC. Nonpremature and non extremely low birth weight premature infants only scored ≥3 risk factors in 32.6% and 15%, respectively. Fluconazole was the most common antifungal used (76.7% of all prescriptions), and commonly underdosed as treatment. The number of microbiological proven IC was low, 5.4%. CONCLUSIONS: Neonatal antifungal prophylaxis is commonly prescribed outside the recommendations based on known risk profiles. Fluconazole is the main antifungal prescribed in neonates and infants, with underdosing frequently observed when prescribed for treatment. Number of proven IC was very low. These observations should be taken into consideration to develop a national pediatric Antifungal Stewardship program aiming to guide rational prescribing.
Item Type: |
Article
|
Additional Information: |
This is a non-final version of an article published in final form in Ferreras-Antolín, L; Irwin, A; Atra, A; Dermirjian, A; Drysdale, SB; Emonts, M; McMaster, P; Paulus, S; Patel, S; Kinsey, S; et al. (2019) Neonatal Antifungal Consumption Is Dominated by Prophylactic Use; Outcomes From The Pediatric Antifungal Stewardship: Optimizing Antifungal Prescription Study. Pediatr Infect Dis J, 38 (12). pp. 1219-1223. |
Keywords: |
1114 Paediatrics And Reproductive Medicine, Pediatrics |
SGUL Research Institute / Research Centre: |
Academic Structure > Infection and Immunity Research Institute (INII) |
Journal or Publication Title: |
Pediatr Infect Dis J |
ISSN: |
1532-0987 |
Language: |
eng |
Dates: |
Date | Event |
---|
December 2019 | Published | 16 September 2019 | Published Online | 31 July 2019 | Accepted |
|
Publisher License: |
Publisher's own licence |
Projects: |
|
PubMed ID: |
31568253 |
![](http://static.pubmed.gov/portal/portal3rc.fcgi/2745237/img/27842) |
Go to PubMed abstract |
URI: |
https://openaccess.sgul.ac.uk/id/eprint/111288 |
Publisher's version: |
https://doi.org/10.1097/INF.0000000000002463 |
Statistics
Item downloaded times since 15 Oct 2019.
Actions (login required)
![Edit Item](/style/images/action_view.png) |
Edit Item |