Pierre Becker1, Pauline Lecerf2, Julie Claereboudt3, Brecht Devleesschauwer4,5, Ann Packeu1, Marijke Hendrickx1. 1. Department of Mycology and Aerobiology, Sciensano, Brussels, Belgium. 2. Dermatology department, University Hospitals Brugmann & Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium. 3. Gynaecology and Obstetrics department, Sainte-Anne Saint-Remi Clinic, CHIREC, Université Libre de Bruxelles, Brussels, Belgium. 4. Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium. 5. Department of Veterinary Public Health and Food Safety, Ghent University, Merelbeke, Belgium.
Abstract
BACKGROUND: Monitoring of superficial mycoses requires more attention due to their important incidence, health costs and antifungal drugs consumption. OBJECTIVES: The objectives were to estimate the burden of superficial mycoses in Belgium and to assess trends in associated antifungal consumption. METHODS: The burden of dermatophytoses (including onychomycosis) as well as skin and genital candidiasis was estimated using Disability-Adjusted Life Years (DALY). Moreover, trends in systemic and topical antifungal consumption in ambulatory care were examined for the period 2010-2017, together with their associated costs. RESULTS: Due to their high incidence and long treatment duration, dermatophytoses represented the bulk of the burden, accounting for 92.2% of the total DALYs of superficial mycoses. Terbinafine was the most prescribed antifungal in terms of doses (35.4% of the total doses) while fluconazole was the most delivered drug in terms of packages (29.1% of the total packages). More than 70% of the prescriptions were made by general practitioners while consumption varied according to age and gender of the patients. A global 12% decrease of antifungal prescriptions was observed between 2011 and 2017. However, this reduction would result mainly from packaging changes and increased self-medication. A significant decrease in itraconazole treatments was notably compensated by an increased prescription of fluconazole packages. CONCLUSION: This study emphasizes that dermatological presentations of superficial mycoses are the most important in terms of both burden and antifungal consumption in Belgium. Further reduction of antifungals use can be achieved by applying the adequate treatment after identification of the causative agent. This article is protected by copyright. All rights reserved.
BACKGROUND: Monitoring of superficial mycoses requires more attention due to their important incidence, health costs and antifungal drugs consumption. OBJECTIVES: The objectives were to estimate the burden of superficial mycoses in Belgium and to assess trends in associated antifungal consumption. METHODS: The burden of dermatophytoses (including onychomycosis) as well as skin and genital candidiasis was estimated using Disability-Adjusted Life Years (DALY). Moreover, trends in systemic and topical antifungal consumption in ambulatory care were examined for the period 2010-2017, together with their associated costs. RESULTS: Due to their high incidence and long treatment duration, dermatophytoses represented the bulk of the burden, accounting for 92.2% of the total DALYs of superficial mycoses. Terbinafine was the most prescribed antifungal in terms of doses (35.4% of the total doses) while fluconazole was the most delivered drug in terms of packages (29.1% of the total packages). More than 70% of the prescriptions were made by general practitioners while consumption varied according to age and gender of the patients. A global 12% decrease of antifungal prescriptions was observed between 2011 and 2017. However, this reduction would result mainly from packaging changes and increased self-medication. A significant decrease in itraconazole treatments was notably compensated by an increased prescription of fluconazole packages. CONCLUSION: This study emphasizes that dermatological presentations of superficial mycoses are the most important in terms of both burden and antifungal consumption in Belgium. Further reduction of antifungals use can be achieved by applying the adequate treatment after identification of the causative agent. This article is protected by copyright. All rights reserved.
Authors: Vinoj H Sewberath Misser; Arti Shankar; Ashna Hindori-Mohangoo; Jeffrey Wickliffe; Maureen Lichtveld; Dennis R A Mans Journal: J Public Health Epidemiol Date: 2021-11-30