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Antifungal Prescription and Stewardship in Pediatrics

Paschalis Evangelidis1, Elisavet Chorafa1, Maria Kourti1

  • 1Pediatric Infectious Disease Unit, 3rd Department of Pediatrics, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki and Hippokration General Hospital, Thessaloniki, Greece.

Mycopathologia
|October 25, 2025
PubMed

Insights

Antifungal (AF) stewardship is vital in pediatrics to combat invasive fungal infections, reduce adverse events, and prevent antifungal resistance. Implementing effective AF stewardship programs is essential for vulnerable children.

Area of Science:

  • Pediatric Infectious Diseases
  • Antimicrobial Stewardship
  • Pharmacology

Background:

  • Invasive fungal infections (IFIs) are a significant cause of morbidity and mortality in pediatric patients, particularly those who are immunocompromised or critically ill.
  • Overuse and misuse of antifungal (AF) agents in children contribute to adverse events, toxicity, and the emergence of AF resistance.
  • Effective antimicrobial stewardship, including AF stewardship, is critical for optimizing patient outcomes and managing healthcare costs.

Purpose of the Study:

  • To review existing literature on antifungal prescribing patterns in pediatric populations.
  • To evaluate the current status of pediatric antifungal stewardship programs globally.
  • To provide recommendations for the implementation and improvement of pediatric AF stewardship.

Main Methods:

  • Systematic review of published data on pediatric antifungal prescription patterns.
  • Analysis of current global pediatric antifungal stewardship program initiatives.
  • Synthesis of findings to inform practical implementation strategies.

Main Results:

  • Data on pediatric AF prescription patterns are variable and highlight areas for improvement.
  • Pediatric AF stewardship programs are emerging but require further development and widespread adoption.
  • Evidence suggests a need for standardized guidelines and targeted interventions to optimize AF use in children.

Conclusions:

  • Improving antifungal stewardship in pediatric care is crucial for managing IFIs and mitigating resistance.
  • Enhanced surveillance of AF prescribing and robust stewardship programs are necessary for vulnerable pediatric populations.
  • Collaborative efforts are needed to implement and sustain effective AF stewardship practices worldwide.
Keywords:
AntifungalInvasive fungal diseaseNeonatalPediatricsPrescriptionStewardship

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