Pediatric pharmacology of antifungal agents

Current Fungal Infection Reports 03/2008; 2(1):49-56. DOI: 10.1007/s12281-008-0008-0


Pediatric age groups display important differences in host biology, predisposing conditions, epidemiology, and presentation
of fungal infections relative to the adult population. Over the past decade, major advances have been made in the field of
medical mycology. Most importantly, an array of new antifungal agents has entered the clinical arena. Although pediatric approval
of several of these agents remains to be established, the pediatric development of antifungal agents is moving forward. Invasive
fungal infections will remain important causes for morbidity and mortality in immunocompromised pediatric patients. Although
the availability of new therapeutic options is an important advance, antifungal therapy has become increasingly complex, and
a thorough understanding of the available antifungal armamentarium is essential for the successful management of individual

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    ABSTRACT: Invasive fungal infection in neonatal intensive care units remains a substantial health problem. Neonatal candidiasis is associated with substantial morbidity and mortality rates. This overview focuses primarily on invasive Candida infections in neonates and includes in-depth discussion of the clinical manifestations, risk factors, and treatments for candidiasis in this high-risk population. Strategies for prevention and management of invasive Candida infection, are addressed in the context of clinical studies and trials that have tested the benefits and risks of such therapeutic strategies. When new antifungal agents become available, further studies must be conducted to determine the optimal dosage, emergence of resistance, and safety in neonates. It is critical that each neonatal intensive care unit examine its invasive fungal infection rates and institute evidence-based prevention, including antifungal prophylaxis, in its high-risk patients and to have guidelines for appropriate antifungal dosing for treatment with central line removal to reduce the incidence and severity of invasive fungal infection in neonates. (J Pediatr 2010; 156: S53-67).
    Journal of Pediatrics 04/2010; 156(4):A1–S86. DOI:10.1016/j.jpeds.2009.11.074 · 3.79 Impact Factor

  • Journal of Pediatrics 04/2010; 156(4):A1-S86. DOI:10.1016/j.jpeds.2009.11.075 · 3.79 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Pediatric fungal infections are a substantial problem and account for substantial morbidity and mortality in young patients. This overview of pediatric fungal infections focuses primarily on candidiasis, the most common type of invasive fungal infection. It includes discussion on the incidence, risk factors, attributable mortality, and hospitalization related to pediatric candidiasis. An update on other pediatric fungal infections, including aspergillosis and zygomycosis, also is provided, to include aspects of incidence, risk factors, and treatment. The conclusion of this overview is the need for further studies, additional multicenter trials, and a concerted effort to encourage the exchange of data and ideas among international investigators who seek to eradicate the problem of pediatric fungal infections. (J Pediatr 2010; 156: S47-52).
    Journal of Pediatrics 04/2010; 156(4):A1–S86. DOI:10.1016/j.jpeds.2009.11.073 · 3.79 Impact Factor
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