The Effect of the Pandemic on Antifungal Use: What Has Changed?

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Avkan Oğuz V., Irmak Ç., Dağdeviren K., Eren Kutsoylu O. Ö., Nazlı A., Çelik M., ...Daha Fazla

Infectious Diseases and Clinical Microbiology, cilt.4, sa.3, ss.156-162, 2022 (Hakemli Dergi)

Özet

Objective: During the COVID-19 pandemic, antimicrobial and antifungal stewardship pro-grams have lost their priority.  Although all parenteral antifungals were used with the rec-ommendations of infectious diseases specialists in the pre-pandemic period, most consul-tations were delayed during the pandemic because of the workload of infectious diseasesspecialists. In this period, antifungal treatments in hospitalized patients were managed bymostly primary physicians. Therefore, we aimed to detect the change in the consumptionof antifungals during the pandemic.Materials and Methods:  The data on the antifungal drug use by month and clinics, thenumber of beds, and the occupancy rate of the clinics were obtained from the hospitalinformation registration system. We defined each drug according to the World HealthOrganization Anatomical Therapeutic Chemical (WHO ATC) coding system and determinedthe defined daily dose (DDD). The antifungal consumption (DDD/ 100 bed-days) in pre-pan-demic and pandemic periods was compared.Results: During the pandemic, the antifungal consumption increased two-fold (2019:7.43;2020:18.03 DDD/100 bed-days). The highest antifungal consumption rate was in the he-matology- oncology-hematopoietic stem cell transplantation (HSCT) clinics with 2.5-fold(2019:39.86; 2020:98.48 DDD/ 100 bed-days) increase.  Liposomal amphotericin B consump-tion made up the majority of this with a four-fold increase in the hematology-oncolo-gy-HSCT clinics.Conclusion: We detected a dramatic increase in antifungal consumption in both ICUs andinpatient clinics during pandemic. A novel antifungal stewardship approach is urgentlyneeded Objective: During the COVID-19 pandemic, antimicrobial and antifungal stewardship programs have lost their priority.  Although all parenteral antifungals were used with the recommendations of infectious diseases specialists in the pre-pandemic period, most consultations were delayed during the pandemic because of the workload of infectious diseases specialists. In this period, antifungal treatments in hospitalized patients were managed by mostly primary physicians. Therefore, we aimed to detect the change in the consumption of antifungals during the pandemic. Materials and Methods:  The data on the antifungal drug use by month and clinics, the number of beds, and the occupancy rate of the clinics were obtained from the hospital information registration system. We defined each drug according to the World Health Organization Anatomical Therapeutic Chemical (WHO ATC) coding system and determined the defined daily dose (DDD). The antifungal consumption (DDD/ 100 bed-days) in pre-pandemic and pandemic periods was compared. Results: During the pandemic, the antifungal consumption increased two-fold (2019:7.43; 2020:18.03 DDD/100 bed-days). The highest antifungal consumption rate was in the hematology- oncology-hematopoietic stem cell transplantation (HSCT) clinics with 2.5-fold (2019:39.86; 2020:98.48 DDD/ 100 bed-days) increase.  Liposomal amphotericin B consumption made up the majority of this with a four-fold increase in the hematology-oncology-HSCT clinics. Conclusion: We detected a dramatic increase in antifungal consumption in both ICUs and inpatient clinics during pandemic. A novel antifungal stewardship approach is urgently needed.