ArticleAntimicrobial agents and chemotherapy2015
Systemic antifungal prescribing in neonates and children: outcomes from the Antibiotic Resistance and Prescribing in European Children (ARPEC) Study.
Article in Antimicrobial agents and chemotherapy, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers.
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Who cites it
28 citing papers in PubMed, 57 citations in OpenAlex.
- Trends in antifungal use characteristics in primary care in Spain, 2019 to 2024: a nationwide study.Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2026Observational
- Irrational and Inappropriate Use of Antifungals in the NICU: A Narrative Review.Antibiotics (Basel, Switzerland) · 2026Review
- Antifungal Stewardship in the Pediatric Intensive Care Unit: Time is of the Essence.Infection and drug resistance · 2026Review
- Antifungal Prescription and Stewardship in Pediatrics.Mycopathologia · 2025Review
- Article
- Perspectives on the Use of Echinocandins in the Neonatal Intensive Care Unit.Antibiotics (Basel, Switzerland) · 2024Review
- Population pharmacokinetics of fluconazole for prevention or treatment of invasive candidiasis in Chinese young infants.Naunyn-Schmiedeberg's archives of pharmacology · 2024Article
- Recent Challenges in Diagnosis and Treatment of Invasive Candidiasis in Neonates.Children (Basel, Switzerland) · 2024Review
- Use of antimicrobials in pediatric wards of five Brazilian hospitals.BMC pediatrics · 2024Observational
- A Practical Guide to Antifungal Susceptibility Testing.Journal of the Pediatric Infectious Diseases Society · 2023Article
- Study of Prescription-Indication of Outpatient Systemic Anti-Fungals in a Colombian Population. A Cross-Sectional Study.Antibiotics (Basel, Switzerland) · 2022Article
- Characteristics of antifungal utilization for hospitalized children in the United States.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2022Article
- Antifungal stewardship in a tertiary care paediatric hospital: the PROAFUNGI study.BMC infectious diseases · 2021Observational
- The Point Prevalence Survey Research of Antibacterial Drugs' Prescription for Outpatient Treatment of Urinary System Infections.Open access Macedonian journal of medical sciences · 2019Article
- A pilot point prevalence study of antimicrobial drugs in indoor patients of a teaching hospital in Central India.Journal of family medicine and primary care · 2019Article
- Management of Invasive Fungal Disease in Neonates and Children.The Pediatric infectious disease journal · 2019Article
- Twenty Years of the SENTRY Antifungal Surveillance Program: Results forOpen forum infectious diseases · 2019Article
- Invasive Aspergillosis in Pediatric Leukemia Patients: Prevention and Treatment.Journal of fungi (Basel, Switzerland) · 2019Review
- Advances in the Treatment of Mycoses in Pediatric Patients.Journal of fungi (Basel, Switzerland) · 2018Review
- Variability in antifungal utilization among neonatal, pediatric, and adult inpatients in academic medical centers throughout the United States of America.BMC infectious diseases · 2018Article
Corrections and comments
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Authors and funding
9 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The appropriate use of systemic antifungals is vital in the prevention and treatment of invasive fungal infection (IFI) in immunosuppressed children and neonates. This multicenter observational study describes the inpatient prescribing practice of antifungal drugs for children and neonates and identifies factors associated with prescribing variability. A single-day point prevalence study of antimicrobial use in hospitalized neonates and children was performed between October and December 2012. The data were entered through a study-specific Web-based portal using a standardized data entry protocol. Data were recorded from 17,693 patients from 226 centers. A total of 136 centers recorded data from 1,092 children and 380 neonates receiving at least one antifungal agent. The most frequently prescribed systemic antifungals were fluconazole (n=355) and amphotericin B deoxycholate (n=195). The most common indications for antifungal administration in children were medical prophylaxis (n=325), empirical treatment of febrile neutropenia (n=122), and treatment of confirmed or suspected IFI (n=100 [14%]). The treatment of suspected IFI in low-birthweight neonates accounted for the majority of prescriptions in the neonatal units (n=103). An analysis of variance (ANOVA) demonstrated no significant effect of clinical indication (prophylaxis or treatment of systemic or localized infection) on the total daily dose (TDD). Fewer than one-half of the patients (n=371) received a TDD within the dosing range recommended in the current guidelines. Subtherapeutic doses were prescribed in 416 cases (47%). The predominance of fluconazole and high incidence of subtherapeutic doses in participating hospitals may contribute to suboptimal clinical outcomes and an increased predominance of resistant pathogenic fungi. A global consensus on antifungal dosing and coordinated stewardship programs are needed to promote the consistent and appropriate use of antifungal drugs in neonates and children.
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