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AuthorPathadka, Swathi
AuthorYan, Vincent K.C.
AuthorNeoh, Chin Fen
AuthorAl-Badriyeh, Daoud
AuthorKong, David C.M.
AuthorSlavin, Monica A.
AuthorCowling, Benjamin J.
AuthorHung, Ivan F.N.
AuthorWong, Ian C.K.
AuthorChan, Esther W.
Available date2023-03-30T07:30:19Z
Publication Date2022-07-01
Publication NameDrugs
Identifierhttp://dx.doi.org/10.1007/s40265-022-01751-x
CitationPathadka, S., Yan, V.K.C., Neoh, C.F. et al. Global Consumption Trend of Antifungal Agents in Humans From 2008 to 2018: Data From 65 Middle- and High-Income Countries. Drugs 82, 1193–1205 (2022). https://doi.org/10.1007/s40265-022-01751-x
ISSN00126667
URIhttps://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85135772202&origin=inward
URIhttp://hdl.handle.net/10576/41513
AbstractBackground: Understanding the trend of global antifungal agent consumption could assist with identification of global healthcare policy inadequacies and promote accessibility and availability of antifungal agents. Methods: Using pharmaceutical sales data from the IQVIA-multinational integrated data analysis system database, we assessed use of systemic antifungal agents in humans in 27 middle- and 38 high-income countries from 2008 through 2018. Results: Consumption of systemic antifungal agents increased from 0.50 (in 2008) to 0.92 defined daily dose (DDD)/1000 inhabitants/day (in 2018), with a compound annual growth rate of 6.2%. High-income countries remain major consumers of antifungal agents with large variance in quantities consumed, with a gradual decline in consumption in recent years. Consumption in middle-income countries increased. Itraconazole (0.32 DDD/1000 inhabitants/day), terbinafine (0.30 DDD/1000 inhabitants/day), and fluconazole (0.23 DDD/1000 inhabitants/day) were the most commonly used antifungal agents in middle- and high-income countries in 2018. Following incorporation into the World Health Organization Essential Medicines List, itraconazole consumption in middle-income countries surged. Consumption of ketoconazole slowly declined, with 5.04% annual decrease, probably due to labelling changes in 2013 to reflect hepatotoxicity concerns. The use of polyenes (0.004 DDD/1000 inhabitants/day) and echinocandins (0.003 DDD/1000 inhabitants/day) were lowest among all the antifungal drug classes. Conclusion: Global consumption of triazoles and terbinafine has gradually increased in middle- and high-income countries. Life-saving antifungal agents, including echinocandins and polyenes, are available only parenterally and may be underutilized, mainly in middle-income countries. Future research on country-specific epidemiology is warranted to guide health policy coordination to ensure equitable access to appropriate use of antifungal agents.
Languageen
PublisherSpringer
SubjectAntifungal Agents
Fungal infections
Terbinafine
TitleGlobal Consumption Trend of Antifungal Agents in Humans From 2008 to 2018: Data From 65 Middle- and High-Income Countries
TypeArticle
Pagination1193-1205
Issue Number11
Volume Number82
dc.accessType Open Access


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