Pattern of use and resistance of antifungal drugs and its prognosis in children hospitalized in Tabriz children’s hospital: A prospective cohort study

Abstract

Children's health indicators are unique in expressing societies' health status. In the meantime, fungal diseases are also of particular importance. Therefore, sufficient knowledge of the variety and frequency of common fungal diseases in these ages is essential in health systems. This study aims to determine the pattern of use and resistance of antifungal drugs and their prognosis in children admitted to a children's educational center for one year. Materials and Methods: In this prospective cohort study that was done among hospitalized children under the age of 15, patients who were diagnosed with a fungal infection or were prescribed antifungal drugs based on clinical symptoms from entering the study until the time of recovery. Alternatively, death was investigated. Data related to the study were collected using a demographic profile questionnaire and a questionnaire related to the characteristics of the disease and prescribed drugs. Results: In this study, 205 hospitalized children with an average age of 36 months were examined regarding the status of prescribing antifungal drugs. The most common underlying disease was ALL, followed by sepsis. Also, the most common cause of antifungal drug prescription was fever and neutropenia, followed by positive blood and urine cultures in patients. Prophylaxis also accounted for 6.8% of prescription cases. The most common antifungal drug prescribed in the studied patients was liposomal amphotericin, which accounted for 60% of cases. The mortality rate of patients was 23.9%, and it was observed that in patients with positive culture, the most common drug resistance was related to caspofungin. In patients with negative culture, it was related to liposomal amphotericin.