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.
Authors
- Pere Soler‐Palacín (ORCID: https://orcid.org/0000-0002-0346-5570)
- Thomas Lehrnbecher (ORCID: https://orcid.org/0000-0002-6022-3439)
- Susanna Esposito (ORCID: https://orcid.org/0000-0003-4103-2837)
- Carlos Grasa (ORCID: https://orcid.org/0000-0002-9323-2024)
- Εlias Iosifidis (ORCID: https://orcid.org/0000-0001-9881-451X)
- Maria Noni (ORCID: https://orcid.org/0000-0002-9741-7966)
- Elio Castagnola (ORCID: https://orcid.org/0000-0002-5336-8429)
- Εvgenia Papakonstantinou (ORCID: https://orcid.org/0000-0001-5620-7885)
- Elisavet Chorafa
- Fernando Baquero‐Artigao (ORCID: https://orcid.org/0000-0002-6903-3826)
- Ignė Kairienė (ORCID: https://orcid.org/0000-0002-5557-658X)
- Marieke Emonts (ORCID: https://orcid.org/0000-0002-2822-3527)
- Kara Tedford
- Ángela Manzanares (ORCID: https://orcid.org/0000-0002-4230-5035)
- Jelena Rascon (ORCID: https://orcid.org/0000-0003-4420-6943)
- Andreas H. Groll (ORCID: https://orcid.org/0000-0003-1188-393X)
- Borbála Zsigmond (ORCID: https://orcid.org/0000-0002-3963-4962)
- Natalia Mendoza‐Palomar (ORCID: https://orcid.org/0000-0002-2035-8291)
- Emmanuel Roilides (ORCID: https://orcid.org/0000-0002-0202-364X)
- Volker Strenger (ORCID: https://orcid.org/0000-0002-6947-5894)
- Stéphane Paulus (ORCID: https://orcid.org/0000-0002-0703-9114)
- Roger J. M. Brüggemann (ORCID: https://orcid.org/0000-0002-7618-725X)
- Adilia Warris (ORCID: https://orcid.org/0000-0001-6586-3358)
- Kornelija Kildonaviciute (ORCID: https://orcid.org/0009-0008-2929-7000)
- Aisha Alkhaaldi
- Thomas Perwein (ORCID: https://orcid.org/0000-0001-6952-1339)
- Valentina Fainardi (ORCID: https://orcid.org/0000-0003-4601-7484)
- Elisabetta Ghimenton-Walters
- Ana Felisa Hurtado Guerrero (ORCID: https://orcid.org/0000-0002-2816-6235)
- Maria Kourti (ORCID: https://orcid.org/0000-0001-5566-9295)
- Manuel Gijón
- Г. Г. Солопова (ORCID: https://orcid.org/0000-0002-1680-7269)
- Andrea Oletto (ORCID: https://orcid.org/0000-0001-9089-4770)
- Daniel Ebrahimi‐Fakhari (ORCID: https://orcid.org/0000-0002-3097-141X)
- Elena María Rincón‐López (ORCID: https://orcid.org/0000-0002-0982-1636)
- Benhur Şirvan Çetin (ORCID: https://orcid.org/0000-0002-8470-4907)
- Laura Ferreras (ORCID: https://orcid.org/0000-0003-2871-1747)
- Alessio Mesini
- Vassiliki Spoulou
- Christina Tzika
Institutions
- Goethe University Frankfurt (DE)
- University of Parma (IT)
- Radboud University Nijmegen (NL)
- Vilnius University (LT)
- National and Kapodistrian University of Athens (GR)
- Medical University of Graz (AT)
- University of Exeter (GB)
- Hospital Universitario La Paz (ES)
- St George’s University Hospitals NHS Foundation Trust (GB)
- Instituto de Salud Carlos III (ES)
- Istituto Giannina Gaslini (IT)
- Newcastle upon Tyne Hospitals NHS Foundation Trust (GB)
- Radboud University Medical Center (NL)
- Hospital General Universitario Gregorio Marañón (ES)
- Children's Health Ireland at Crumlin (IE)
- Heim Pál Országos Gyermekgyógyászati Intézet (HU)
- Research Institute Hospital 12 de Octubre (ES)
- PENTA Foundation (IT)
- Canisius-Wilhelmina Ziekenhuis (NL)
- Centro de Investigación Biomédica en Red (ES)
- Ippokrateio General Hospital of Thessaloniki (GR)
- Children's Hospital Agia Sophia (GR)
- Dmitry Rogachev National Research Center of Pediatric Hematology, Oncology and Immunology (RU)
- Vall d'Hebron Hospital Universitari (ES)
- Great North Children's Hospital (GB)
- Oxford University Hospitals NHS Trust (GB)
- Istituti di Ricovero e Cura a Carattere Scientifico (IT)
- Hippocration General Hospital (GR)
- Newcastle University (GB)
- Erciyes University (TR)
- Medical Research Council (GB)
Publication Details
- Journal
- Journal of Pediatric Hematology/Oncology
- Published
- 2025-06-20
- DOI
- https://doi.org/10.1097/mph.0000000000003070
- Citations
- 1
- Primary Topic
- Antifungal resistance and susceptibility
- Type
- article
- Field-Weighted Citation Impact
- 1.40