The following is the summary of “Impact of COVID-19 pandemic on antifungal consumption: a multicenter retrospective analysis” published in the December 2022 issue of Critical care by Bienvenu, et al.

In the context of the COVID-19 pandemic, excessive use of antifungals may have been practiced in our hospitals, much as excessive use of antibacterials has been recorded in the past. To explore the impact that COVID-19 has had on the use of antifungal medication, a multicenter retrospective analysis was carried out. This study included 14 intensive care units (ICU) and four medical locations. The consumption of antifungals and the incidence of invasive fungal illnesses before and during the COVID-19 pandemic were described for patients who did not have COVID-19 and those who did have COVID-19.

 While the incidence of invasive aspergillosis significantly increased in slightly lower proportions in the ICU (+46%), there was an increase in the consumption of voriconazole in 2020 compared with 2019 for both the entire hospital as well as the ICU (+40.3% and +63.7%, respectively). This was observed even though there was also an increase in the number of patients receiving treatment in the ICU. Caspofungin consumption also increased in 2020 compared to 2019 for the entire hospital and the intensive care unit (ICU) (+34.9% and +17.0%, respectively). This was in conjunction with an increased incidence of invasive candidiasis in both the entire hospital and the ICU, albeit in lower proportions (+20.0% and +10.0%, respectively).

During the COVID-19 pandemic, their hospital saw an increase in the use of antifungals such as voriconazole and caspofungin, which can be partially explained by the higher rate of invasive fungal illnesses seen in COVID-19 patients. These findings are of the utmost relevance because they raise concerns about the urgent need for adequate antifungal stewardship activities to control the use of antifungal drugs.