Impact of COVID-19 pandemic on antifungal consumption: a multicenter retrospective analysis
Anne‐Lise Bienvenu, A. Bestion, Pierre Pradat, Jean‐Christophe Richard, Laurent Argaud, Céline Guichon, Sandrine Roux, Vincent Piriou, Carole Paillet, Gilles Leboucher, the Antifungal study group, Florence Ader, Frédéric Aubrun, Charlotte Besson, Valentine Bréant, Charlotte Doudet, Sophie Ducastelle-Leprêtre, Damien Dupont, Marie-Delphine Guillemin, Véronique Leray, Charline Miossec, S. Paulus, Anne-Marie Rabain, Pauline Rascle, Thomas F. Schulz, Michel Tod, Florent Valour, Florent Wallet, Martine Wallon
Abstract
BACKGROUND: In the context of COVID-19 pandemic, antifungal overuse may have occurred in our hospitals as it has been previously reported for antibacterials. METHODS: To investigate the impact of COVID-19 on antifungal consumption, a multicenter retrospective study including four medical sites and 14 intensive care units (ICU) was performed. Antifungal consumption and incidences of invasive fungal diseases before and during COVID-19 pandemic, for non-COVID-19 patients and COVID-19 patients, were described. RESULTS: An increase in voriconazole consumption was observed in 2020 compared with 2019 for both the whole hospital and the ICU (+ 40.3% and + 63.7%, respectively), whereas the incidence of invasive aspergillosis significantly increased in slightly lower proportions in the ICU (+ 46%). Caspofungin consumption also increased in 2020 compared to 2019 for both the whole hospital and the ICU (+ 34.9% and + 17.0%, respectively) with an increased incidence of invasive candidiasis in the whole hospital and the ICU but in lower proportions (+ 20.0% and + 10.9%, respectively). CONCLUSIONS: We observed an increased consumption of antifungals including voriconazole and caspofungin in our hospital during the COVID-19 pandemic and explained in part by an increased incidence of invasive fungal diseases in COVID-19 patients. These results are of utmost importance as it raises concern about the urgent need for appropriate antifungal stewardship activities to control antifungal consumption.