Antifungal consumption in hematology, intensive care units and at hospital level in French hospitals in 2024.

OBJECTIVES: In healthcare facilities, the expanding population of immunocompromised patients, associated with the emergence of antifungal-resistant pathogens, highlights the need for surveillance of antifungal consumption. This study aimed to provide an updated overview of systemic antifungal use in French hospitals, with a particular focus on hematology wards and intensive care units (ICUs). METHODS: A retrospective study was conducted among voluntary hospitals using the national surveillance methodology. Data included quantities of antifungals dispensed in inpatient wards at hospital level, ICUs and hematology wards, as well as the number of patient-days (PD). Consumption was expressed as defined daily doses (DDD) per 1,000 PD. RESULTS: A total of 684 hospitals participated, including 33 hematology wards and 139 ICUs. Overall antifungal consumption was 15.7 DDD/1,000 PD, with higher consumption in hematology wards (355.8 DDD/1,000 PD) and ICUs (130.2 DDD/1,000 PD). The most frequently used antifungal agents were fluconazole (49.8%), posaconazole (16.3%), and caspofungin (15.7%). In ICUs, fluconazole (38.6%), caspofungin (31.8%) and voriconazole (9.0%) predominated, whereas in hematology wards posaconazole (43.7%) was the most used antifungal, followed by fluconazole (24.1%) and voriconazole (12.3%). Antifungal consumption varied among wards and hospitals. CONCLUSION: Consumption patterns were consistent with current recommendations. Variations between wards may reflect differences in patient populations and prophylactic or therapeutic prescribing practices. Continued national surveillance, combined with prescribing practice evaluations and studies of local fungal ecology, will contribute to optimizing antifungal prescribing.