{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T03:56:45Z","timestamp":1789617405510,"version":"build-2803163510"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and objectives<\/jats:title>\n                    <jats:p>Fungal infections cause substantial morbidity and mortality. Monitoring antifungal use is a foundational aspect of antifungal stewardship, particularly as new disease-causing fungi emerge and antifungal resistance spreads. We assessed recent patterns in systemic antifungal medication use among hospitalized patients within a diverse convenience sample of academic medical centres and community hospitals in the USA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a multicentre retrospective cohort study using the Vizient\u00ae Clinical Data Base. We selected hospitalized patients who received \u22651 dose of systemic antifungal medication during 2018\u201323 and assessed antifungal days of therapy (DOT) per 1000 patient days. We stratified antifungal DOT by National Comprehensive Cancer Network (NCCN) cancer centre status to compare antifungal use at hospitals with an NCCN-designated cancer centre\u2014some of which also include a main academic medical centre and non-cancer service lines\u2014versus hospitals without an NCCN-designated cancer centre.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 39\u200a956\u200a873 discharges from 412 hospitals, the proportion of patients who received any systemic antifungal was 4.5%; azoles (3.8%) were the most common antifungal class, followed by echinocandins (0.9%). Overall antifungal DOT were 53.7 per 1000 patient days (114.5 among 25 NCCN hospitals and 43.2 among 387 non-NCCN hospitals).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Substantial antifungal use occurs among hospitalized patients, particularly among those with cancer. The growing population susceptible to fungal infections (e.g. transplants, cancer and other immunosuppressing conditions) warrants consideration of antifungal stewardship and evaluation of appropriateness of antifungal use in the context of increasing resistance.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jac\/dkaf269","type":"journal-article","created":{"date-parts":[[2025,7,21]],"date-time":"2025-07-21T11:18:25Z","timestamp":1753096705000},"page":"2659-2664","source":"Crossref","is-referenced-by-count":5,"title":["Trends in antifungal use among hospitalized patients in the USA, 2018\u201323"],"prefix":"10.1093","volume":"80","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5707-528X","authenticated-orcid":false,"given":"Dallas J","family":"Smith","sequence":"first","affiliation":[{"name":"Mycotic Diseases Branch, Centers for Disease Control and Prevention , 1600 Clifton Road NE, Mailstop H24-11, Atlanta, GA 30329 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Diseases, The University of Texas MD Anderson Cancer Center , Houston, TX ,","place":["USA"]},{"name":"Department of Pharmacy, The University of Texas MD Anderson Cancer Center , Houston, TX ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alyssa H","family":"Harris","sequence":"additional","affiliation":[{"name":"Vizient Inc. , Irving, TX ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teny M","family":"John","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, The University of Texas MD Anderson Cancer Center , Houston, TX ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,8,11]]},"reference":[{"key":"2025100314222833800_dkaf269-B1","doi-asserted-by":"publisher","first-page":"ofab593","DOI":"10.1093\/ofid\/ofab593","article-title":"Prevalence and healthcare burden of fungal infections in the United States, 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