Table 2.
Antifungal Prescription Characteristics and Adequacy
| Total | Prophylaxis | Treatment | ||
|---|---|---|---|---|
| Antifungal prescriptions, n | 119 | 75 | 44 | |
| Indication for AF therapy | ||||
| Primary prophylaxis, n (%) | 70 (58.8) | 70 (93.3) | ||
| Secondary prophylaxis, n (%) | 5 (4.4) | 5 (6.7) | ||
| Empirical therapy, n (%) | 30 (25) | 30 (68.2) | ||
| Pre-emptive therapy, n (%) | 1 (0.8) | 1 (2.3) | ||
| Targeted therapy, n (%) | 13 (11) | 13 (29.5) | ||
| Underlying disease | ||||
| Cancer, n (%) | 64 (54) | 48 (64) | 16 (36.4) | |
| HSCT, n (%) | 43/64 (67) | 35/48 (73) | 8/16 (50) | |
| Critical paediatric patients, n (%) | 29 (24) | 16 (21.4) | 13 (29.5) | |
| Critical newborns, n (%) | 7 (6) | 3 (4) | 4 (9.1) | |
| Primary immunodeficiencies, n (%) | 11 (9) | 7 (9.3) | 4 (9.1) | |
| Solid organ transplant, n (%) | 3 (3) | 0 (0) | 3 (6.8) | |
| Other, n (%) | 5 (4) | 1 (1.3) | 4 (9.1) | |
| AF agent | ||||
| Liposomal amphotericin B, n (%) | 55 (46.2) | 41 (54.6) | 14 (32) | |
| Posaconazole, n (%) | 21 (17.7) | 21 (28) | 0 (0) | |
| Anidulafungin, n (%) | 13 (10.9) | 3 (4) | 10 (23) | |
| Fluconazole, n (%) | 12 (10.1) | 6 (8) | 6 (14) | |
| Micafungin, n (%) | 6 (5.0) | 2 (2.7) | 4 (9) | |
| Isavuconazole, n (%) | 5 (4.2) | 0 (0) | 5 (11) | |
| Voriconazole, n (%) | 4 (3.4) | 0 (0) | 4 (9) | |
| Itraconazole, n (%) | 2 (1.7) | 2 (2.7) | 0 (0) | |
| Caspofungin, n (%) | 1 (0.8) | 0 (0) | 1 (2) | |
| Antifungal prescription evaluations, n | 219 | 144 | 75 | |
| Non-optimal prescriptions, n (%) | 24 (11) | 12 (8) | 12 (16) | |
| Unnecessary, n (%) | 14 (6) | 10 (7) | 4 (5) | |
| Inappropriate, n (%) | 2 (1) | 0 (0) | 2 (3) | |
| Inadequate | Incorrect dose, n (%) | 7 (3) | 4 (3) | 3 (4) |
| Incorrect route of administration, n (%) | 0 (0) | 0 (0) | 0 (0) | |
| Incorrect duration, n (%) | 7 (3) | 7 (5) | 0 (0) | |
| Disagreement with institutional protocol, when available, n (%) | 12 (8)a | 4 (3)a | 8 (20)a | |
| Non-optimal prescription distribution among underlying disease, n (%) | ||||
| Cancer | 4 (16.7) | 2 (16.7) | 2 (16.7) | |
| HSCT, n (%) | 4/4 (100) | 2/2 (100) | 2/2 (100) | |
| Critical paediatric patients, n (%) | 14 (58.3) | 8 (66.7) | 6 (50) | |
| Critical newborns, n (%) | 1 (4.2) | 1 (8.3) | 0 (0) | |
| Primary immunodeficiencies, n (%) | 1 (4.2) | 1 (8.3) | 0 (0) | |
| Solid organ transplant, n (%) | 1 (4.2) | 0 (0) | 1 (8.3) | |
| Other, n (%) | 3 (12.5) | 0 (0) | 3 (25) | |
Abbreviations: AF antifungal
a Calculated as a percentage of the prescriptions for which a local institutional protocol was available: 157 total, 117 prophylaxis, 40 treatment