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Antifungal consumption, indications and selection of antifungal drugs in paediatric tertiary hospitals in Turkey: Results from the first national point prevalence survey   
Yazarlar
İlknur Çağlar
Dr. Behcet Uz Children's Hospital, Turkey
İlker Devrim
Dr. Behcet Uz Children's Hospital, Turkey
Halil Özdemir
Ankara Üniversitesi, Turkey
Zümrüt Şahbudak
Ege University Medical School, Turkey
Gülsüm Sönmez
Çukurova Üniversitesi Tip Fakültesi, Turkey
Ayse Buyukcam
Hacettepe Üniversitesi, Turkey
Belgin Gulhan
Ankara Children's Hematology Oncology Training and Research Hospital, Turkey
Ahu Kara
Dr. Behcet Uz Children's Hospital, Turkey
Deniz F. Aygun
İstanbul University-Cerrahpaşa Cerrahpaşa Faculty of Medicine, Turkey
Nuri Bayram
Dr. Behcet Uz Children's Hospital, Turkey
Solmaz Celebi
Bursa Uludağ Üniversitesi, Turkey
Benhur Çetin
Ortopedy Department of Gaziantep Avukat Cengiz State Hospital, Turkey
Merve Nepesov
Eskişehir Osmangazi Üniversitesi Tip Fakültesi, Turkey
Ayşe T. Yilmaz
Kocaeli Üniversitesi, Turkey
Eda Kepenekli
Marmara Üniversitesi, Turkey
Dilek Yilmaz Çiftdogan
İzmir Kâtip Çelebi Üniversitesi, Turkey
Manolya K. Acar
İstanbul University-Cerrahpaşa Cerrahpaşa Faculty of Medicine, Turkey
Burcu Cura Yayla
Gazi University, Faculty of Medicine, Turkey
Canan Okumuş
Dokuz Eylül Üniversitesi, Turkey
Zafer Ecevit
Başkent Üniversitesi, Turkey
Nevin Hatipoglu
Bak?rkoy Dr. Sadi Konuk Egitim ve Arast?rma Hastanesi, Turkey
Necdet Kuyucu
Mersin Üniversitesi, Turkey
Muhammed Kosker
Diyarbakir Children's Hospital, Turkey
Semra Sen
Manisa Celâl Bayar Üniversitesi, Turkey
Adem Karbuz
Saǧlik Bakanliǧi Okmeydani Eǧitim ve Araştirma Hastanesi, Turkey
Murat Sutcu
Konya City Hospital, Turkey
Burcu Bursal Duramaz
Bezmiâlem Vakıf Üniversitesi, Turkey
Metehan Özen
Acibadem Mehmet Ali Aydinlar Universitesi, Turkey
Ergin Çiftçi
Ankara Üniversitesi, Turkey
Derya Alabaz
Çukurova Üniversitesi Tip Fakültesi, Turkey
Zafer Kurugol
Ege University Medical School, Turkey
Ateş Kara
Hacettepe Üniversitesi, Turkey
Saliha Kanik
Ankara Children's Hematology Oncology Training and Research Hospital, Turkey
Omer Kilic
Eskişehir Osmangazi Üniversitesi Tip Fakültesi, Turkey
Selim Oncel
Kocaeli Üniversitesi, Turkey
Ayper Somer
İstanbul University-Cerrahpaşa Cerrahpaşa Faculty of Medicine, Turkey
Anil Tapisiz
Gazi University, Faculty of Medicine, Turkey
Nursen Belet
Dokuz Eylül Üniversitesi, Turkey
Özge Metin Akcan
Konya City Hospital, Turkey
Özden Türel
Bezmiâlem Vakıf Üniversitesi, Turkey
Aslinur Ozkaya
Ankara Children's Hematology Oncology Training and Research Hospital, Turkey
Hasan Tezer
Gazi University, Faculty of Medicine, Turkey
Ali Bulent Cengiz
Hacettepe Üniversitesi, Turkey
Erdal İnce
Ankara Üniversitesi, Turkey
Yıldız Camcioglu
İstanbul University-Cerrahpaşa Cerrahpaşa Faculty of Medicine, Turkey
Emine Kocabas
Çukurova Üniversitesi Tip Fakültesi, Turkey
Emin S. Arisoy
Kocaeli Üniversitesi, Turkey
Nuran Salman
İstanbul University-Cerrahpaşa Cerrahpaşa Faculty of Medicine, Turkey
Özet
Objectives: The aim of this point prevalence survey was to evaluate the consumption, indications and strategies of antifungal therapy in the paediatric population in Turkey. Methods: A point prevalence study was performed at 25 hospitals. In addition to general data on paediatric units of the institutes, the generic name and indication of antifungal drugs, the presence of fungal isolation and susceptibility patterns, and the presence of galactomannan test and high-resolution computed tomography (HRCT) results were reviewed. Results: A total of 3338 hospitalised patients were evaluated. The number of antifungal drugs prescribed was 314 in 301 patients (9.0%). Antifungal drugs were mostly prescribed in paediatric haematology and oncology (PHO) units (35.2%), followed by neonatal ICUs (NICUs) (19.6%), paediatric services (18.3%), paediatric ICUs (PICUs) (14.6%) and haematopoietic stem cell transplantation (HSCT) units (7.3%). Antifungals were used for prophylaxis in 147 patients (48.8%) and for treatment in 154 patients (50.0%). The antifungal treatment strategy in 154 patients was empirical in 77 (50.0%), diagnostic-driven in 29 (18.8%) and targeted in 48 (31.2%). At the point of decision-making for diagnostic-driven antifungal therapy in 29 patients, HRCT had not been performed in 1 patient (3.4%) and galactomannan test results were not available in 12 patients (41.4%). Thirteen patients (8.4%) were receiving eight different antifungal combination therapies. Conclusion: The majority of antifungal drugs for treatment and prophylaxis were prescribed in PHO and HSCT units (42.5%), followed by ICUs. Thus, antifungal stewardship programmes should mainly focus on these patients within the availability of diagnostic tests of each hospital.
Anahtar Kelimeler
Antifungals | Indications | Paediatric tertiary hospital | Point prevalence survey
Makale Türü Özgün Makale
Makale Alt Türü SCOPUS dergilerinde yayımlanan tam makale
Dergi Adı Journal of Global Antimicrobial Resistance
Dergi ISSN 2213-7165
Makale Dili İngilizce
Basım Tarihi 12-2018
Cilt No 15
Sayı 1
Sayfalar 232 / 238
Doi Numarası 10.1016/j.jgar.2018.08.007