抗真菌药在欧洲免疫功能低下儿童中的应用:一项为期12周的多中心每周点患病率调查(CALYPSO)。

IF 0.9 4区 医学 Q4 HEMATOLOGY
Elisavet Chorafa, Elias Iosifidis, Andrea Oletto, Adilia Warris, Elio Castagnola, Roger Bruggemann, Andreas H Groll, Thomas Lehrnbecher, Laura F Antolin, Alessio Mesini, Aisha A Alkhaaldi, Fernando Baquero-Artigao, Benhur S Cetin, Daniel Ebrahimi-Fakhari, Marieke Emonts, Susanna Esposito, Valentina Fainardi, Elisabetta Ghimenton-Walters, Manuel Gijón, Alba G Guerrero, Carlos D Grasa, Igne Kairiene, Kornelija Kildonaviciute, Maria Kourti, Angela Manzanares, Natalia Mendoza-Palomar, Maria Noni, Eugenia Papakonstantinou, Stéphane Paulus, Thomas Perwein, Jelena Rascon, Elena Rincón-López, Pere Soler-Palacin, Galina Solopova, Vassiliki Spoulou, Volker Strenger, Kara Tedford, Christina Tzika, Borbala Zsigmond, Emmanuel Roilides
{"title":"抗真菌药在欧洲免疫功能低下儿童中的应用:一项为期12周的多中心每周点患病率调查(CALYPSO)。","authors":"Elisavet Chorafa, Elias Iosifidis, Andrea Oletto, Adilia Warris, Elio Castagnola, Roger Bruggemann, Andreas H Groll, Thomas Lehrnbecher, Laura F Antolin, Alessio Mesini, Aisha A Alkhaaldi, Fernando Baquero-Artigao, Benhur S Cetin, Daniel Ebrahimi-Fakhari, Marieke Emonts, Susanna Esposito, Valentina Fainardi, Elisabetta Ghimenton-Walters, Manuel Gijón, Alba G Guerrero, Carlos D Grasa, Igne Kairiene, Kornelija Kildonaviciute, Maria Kourti, Angela Manzanares, Natalia Mendoza-Palomar, Maria Noni, Eugenia Papakonstantinou, Stéphane Paulus, Thomas Perwein, Jelena Rascon, Elena Rincón-López, Pere Soler-Palacin, Galina Solopova, Vassiliki Spoulou, Volker Strenger, Kara Tedford, Christina Tzika, Borbala Zsigmond, Emmanuel Roilides","doi":"10.1097/MPH.0000000000003070","DOIUrl":null,"url":null,"abstract":"<p><p>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.</p>","PeriodicalId":16693,"journal":{"name":"Journal of Pediatric Hematology/Oncology","volume":" ","pages":""},"PeriodicalIF":0.9000,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Antifungal Use in Immunocompromised Children in Europe: A 12-Week Multicenter Weekly Point Prevalence Survey (CALYPSO).\",\"authors\":\"Elisavet Chorafa, Elias Iosifidis, Andrea Oletto, Adilia Warris, Elio Castagnola, Roger Bruggemann, Andreas H Groll, Thomas Lehrnbecher, Laura F Antolin, Alessio Mesini, Aisha A Alkhaaldi, Fernando Baquero-Artigao, Benhur S Cetin, Daniel Ebrahimi-Fakhari, Marieke Emonts, Susanna Esposito, Valentina Fainardi, Elisabetta Ghimenton-Walters, Manuel Gijón, Alba G Guerrero, Carlos D Grasa, Igne Kairiene, Kornelija Kildonaviciute, Maria Kourti, Angela Manzanares, Natalia Mendoza-Palomar, Maria Noni, Eugenia Papakonstantinou, Stéphane Paulus, Thomas Perwein, Jelena Rascon, Elena Rincón-López, Pere Soler-Palacin, Galina Solopova, Vassiliki Spoulou, Volker Strenger, Kara Tedford, Christina Tzika, Borbala Zsigmond, Emmanuel Roilides\",\"doi\":\"10.1097/MPH.0000000000003070\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>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.</p>\",\"PeriodicalId\":16693,\"journal\":{\"name\":\"Journal of Pediatric Hematology/Oncology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":0.9000,\"publicationDate\":\"2025-06-20\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Pediatric Hematology/Oncology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/MPH.0000000000003070\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"HEMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Pediatric Hematology/Oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/MPH.0000000000003070","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"HEMATOLOGY","Score":null,"Total":0}
引用次数: 0

摘要

我们通过对11个欧洲国家18家医院的31个血液肿瘤学(HO)和造血干细胞/实体器官移植(HSCT/SOT)单位进行为期12周的多中心点患病率调查,前瞻性地分析了免疫功能低下儿童抗真菌药物的使用情况。所有住院并接受全身抗真菌药物治疗的患者均被纳入研究。收集病房政策和每周病房/患者数据。所有21个HO和10个HSCT/SOT单位都有针对高危患者的预防政策(27/31使用唑类药物,14/31使用棘白菌素,15/31使用两性霉素B脂质体[LAMB])。在记录的572个疗程中,439/572(77%)需要预防,133/572需要治疗(62/133是经验性的,43/133是预防性的,28/133是针对性的)。在接受预防治疗的患者中,56%属于非高危组。经验性、预防性和针对性治疗的最常见原因分别是抗生素耐药发热性中性粒细胞减少症(52%)、胸部ct异常伴/不伴半乳甘露聚糖阳性(77%)和念珠菌病(82%)。氟康唑和兰姆是预防(31%,21%)和治疗(32%,23%)最常用的处方药物。在50%的处方中用于治疗的米卡芬净剂量不足,在70%的病例中用于治疗和预防的氟康唑剂量不足。结论:抗真菌处方以预防为主,氟康唑为主要抗真菌处方。剂量不足的抗真菌处方和非高危患者的预防可能是改善的目标。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Antifungal Use in Immunocompromised Children in Europe: A 12-Week Multicenter Weekly Point Prevalence Survey (CALYPSO).

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.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
CiteScore
1.90
自引率
8.30%
发文量
415
审稿时长
2.5 months
期刊介绍: ​Journal of Pediatric Hematology/Oncology (JPHO) reports on major advances in the diagnosis and treatment of cancer and blood diseases in children. The journal publishes original research, commentaries, historical insights, and clinical and laboratory observations.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信