{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T13:46:01Z","timestamp":1785246361136,"version":"3.55.0"},"reference-count":20,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,1,22]],"date-time":"2021-01-22T00:00:00Z","timestamp":1611273600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,1,22]],"date-time":"2021-01-22T00:00:00Z","timestamp":1611273600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100005564","name":"Gilead Sciences","doi-asserted-by":"publisher","award":["IN-ES-131-4501"],"award-info":[{"award-number":["IN-ES-131-4501"]}],"id":[{"id":"10.13039\/100005564","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>The increasing use of antifungal drugs (AF) in children and the concern for related adverse events and costs has led to the development of specific AF stewardship programmes (AFS). Studies in adult patients have shown improvements in AF prescription and usage after implementation, but paediatric data are scant. The aim of this PROAFUNGI study was to describe the use and appropriateness of AF in a high complexity paediatric centre.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Observational, prospective, single-centre, modified point-prevalence study (11 surveys, July\u2013October 2018), including paediatric (&lt;\u200918\u2009years) patients receiving at least one systemic AF. Prescriptions were evaluated by the AFS team.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The study included 119 prescriptions in 55 patients (53% males, median age 8.7\u2009years [IQR 2.4\u201313.8]). The main underlying condition was cancer (45.5% of patients; HSCT in 60% of them); and the first indication for AF was prophylaxis (75 prescriptions, 63.2%). Liposomal amphotericin B was used most commonly (46% prescriptions), mainly as prophylaxis (75%). Among the 219 evaluations, 195 (89%) were considered optimal. The reason for non-optimal prescriptions was mostly lack of indication (14\/24), especially in critical patients with ventricular assist devices. The use of AF without paediatric approval accounted for 8\/24 inappropriate prescriptions.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>A high rate of AF appropriateness was found for the children\u2019s hospital as a whole, in relation with a well-established AFS. Nonetheless, the identification of specific areas of improvement should guide future actions of the AFS team, which will focus mainly on prophylaxis in critically ill patients receiving circulatory assistance and the use of non-approved drugs in children.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12879-021-05774-9","type":"journal-article","created":{"date-parts":[[2021,1,22]],"date-time":"2021-01-22T07:03:21Z","timestamp":1611299001000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Antifungal stewardship in a tertiary care paediatric hospital: the PROAFUNGI study"],"prefix":"10.1186","volume":"21","author":[{"given":"Natalia","family":"Mendoza-Palomar","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatriz","family":"Garcia-Palop","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susana","family":"Melendo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Teresa","family":"Mart\u00edn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Berta","family":"Renedo-Mir\u00f3","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pere","family":"Soler-Palacin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aurora","family":"Fern\u00e1ndez-Polo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,1,22]]},"reference":[{"key":"5774_CR1","doi-asserted-by":"publisher","first-page":"658","DOI":"10.1080\/21505594.2016.1226721","volume":"8","author":"RF Hamdy","year":"2017","unstructured":"Hamdy RF, Zaoutis TE, Seo SK. Antifungal stewardship considerations for adults and pediatrics. Virulence. 2017;8:658\u201372. https:\/\/doi.org\/10.1080\/21505594.2016.1226721.","journal-title":"Virulence"},{"key":"5774_CR2","first-page":"59","volume":"29 Suppl 1","author":"JT Ramos","year":"2016","unstructured":"Ramos JT, Francisco L, Daoud Z. Infecci\u00f3n f\u00fangica invasora en ni\u00f1os: diferencias y homolog\u00edas con el adulto [Invasive fungal infections in children: similarities and differences with adults]. Rev Esp Quimioter. 2016;29 Suppl 1:59\u201365 Spanish. PMID: 27608317.","journal-title":"Rev Esp Quimioter"},{"issue":"4","key":"5774_CR3","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.28145","volume":"67","author":"M Science","year":"2020","unstructured":"Science M, Timberlake K. Antifungal stewardship: a budding branch of antimicrobial stewardship. 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The referred committee granted permission to access and analyse the study data. Patients\u2019 data was anonymised before its use. Study participants consent to participate is not applicable.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not Applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"100"}}