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Impact of COVID-19 pandemic on antifungal consumption: a multicenter retrospective analysis

Anne-Lise Bienvenu1,2, Audrey Bestion3, Pierre Pradat4

  • 1Service Pharmacie, Groupement Hospitalier Nord, Hospices Civils de Lyon, 103 Grande rue de la Croix-Rousse, 69004, Lyon, France. anne-lise.bienvenu@chu-lyon.fr.

Critical Care (London, England)
|December 13, 2022
PubMed
Abstract

Insights

Antifungal use, including voriconazole and caspofungin, increased during the COVID-19 pandemic, partly due to more invasive fungal infections in patients. This highlights the need for antifungal stewardship programs to manage consumption.

Area of Science:

  • Infectious Diseases
  • Critical Care Medicine
  • Pharmacology

Background:

  • The COVID-19 pandemic may have led to increased antifungal use, similar to antibacterial overuse.
  • Fungal infections pose a significant risk, especially in critically ill patients.

Purpose of the Study:

  • To evaluate the impact of the COVID-19 pandemic on antifungal consumption patterns.
  • To compare antifungal use and invasive fungal disease incidence before and during the pandemic.

Main Methods:

  • A multicenter retrospective study was conducted across four medical sites.
  • Data included antifungal consumption and invasive fungal disease incidence in intensive care units (ICUs) and general hospital wards.
  • Patients were categorized as non-COVID-19 and COVID-19.

Main Results:

  • Voriconazole consumption rose by 40.3% (hospital) and 63.7% (ICU) in 2020 vs. 2019; invasive aspergillosis incidence increased by 46% (ICU).
  • Caspofungin consumption increased by 34.9% (hospital) and 17.0% (ICU); invasive candidiasis incidence rose by 20.0% (hospital) and 10.9% (ICU).
  • Increased fungal disease incidence in COVID-19 patients partially explained the rise in antifungal consumption.

Conclusions:

  • Antifungal consumption, specifically voriconazole and caspofungin, significantly increased during the COVID-19 pandemic.
  • The rise in consumption is partly attributed to increased invasive fungal diseases in COVID-19 patients.
  • There is an urgent need for antifungal stewardship programs to optimize antifungal use and prevent resistance.
Keywords:
AntifungalsCOVID-19ConsumptionDefined daily doseInvasive fungal disease

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