Adilia Warris (United Kingdom)

University of Exeter MRC Centre for Medical Mycology
Adilia Warris, M.D., Ph.D., is a professor paediatric infectious diseases specialist with a specific interest in medical mycology. She is co-director of the MRC Centre for Medical Mycology at the University of Exeter, UK. She holds an honorary position in paediatric infectious diseases at Great Ormond Street Hospital in London, UK. Prof Warris’ research profile has a strong translational focus and specific areas of interest include host-fungus interactions in specific patient populations, antifungal resistance and antifungal stewardship, epidemiology and management of fungal diseases in paediatric patient populations, in particularly those with primary immunodeficiency and cystic fibrosis.

Author Of 1 Presentation

ANTIFUNGAL USE IN EUROPEAN PEDIATRIC INTENSIVE CARE UNITS (PICUS): A 12-WEEK MULTICENTER MODIFIED POINT PREVALENCE STUDY (CALYPSO)

Date
Thu, 12.05.2022
Session Time
08:00 - 09:30
Session Type
Parallel Symposium
Room
MC 2 HALL
Lecture Time
09:07 - 09:17

Abstract

Backgrounds:

Knowledge of antifungal use in PICUs across Europe, while frequently prescribed, is limited. A 12-wk modified point-prevalence study was conducted to record antifungal use in Εuropean PICUs.

Methods

All patients hospitalized in the participating PICUs and receiving systemic antifungals were included. Information about ward demographics was collected once at the beginning; weekly ward and patient data were collected prospectively for the 12-wk study period and entered in REDCap database.

Results:

table 1.antifungal agents in picus.png

18 PICUs (15 hospitals), in 10 European countries participated. 8/18 (44%) of PICUs followed prophylactic practices for patients with immunocompromise/neutropenia, long-term parenteral nutrition or central lines, 7/18 (39%) had an antifungal stewardship program implemented and the majority (16/18) used biomarkers (15/16 galactomannan, 12/16 each beta-D-glucan and Cryptococcal antigen). 101 patients with ages ≤90d (14 patients), 3-60mo (44pts) and >5yrs (43pts) were recorded. Malignancy was the most common underlying condition among patients aged >90d (28%) followed by surgery/trauma (25%), whereas all patients ≤90d had previous surgery. Indication for antifungal prescribing was prophylaxis in 38% and treatment in 62% [empirical (57%), preemptive (13%) and targeted (30%)]. Fluconazole was the most common agent both for prophylaxis [45%, median dose: 6 (range 2-9) mg/kg/d] and empirical treatment [53%, median dose: 10 (range 1-12) mg/kg/d], whereas LAMB was the most frequent agent for targeted treatment [37%, median dose: 5 (range 3-6) mg/kg/d] (Table 1). Common reasons for empirical and targeted treatment were persistent fever in high-risk patients (58%) and candidiasis (100%), respectively. For targeted treatment, the most frequent pathogens were Candida albicans (37%) and Candida parapsilosis (32%).

Conclusions/Learning Points:

The majority of antifungal prescriptions across European PICUs were for prophylaxis or empirical treatment. These data will be valueable for guiding antifungal stewardship strategies in PICUs

Hide

Moderator of 1 Session

Session Type
Parallel Symposium
Date
Thu, 12.05.2022
Session Time
08:00 - 09:30
Room
MC 2 HALL