Pediatric pharmacology of antifungal agents

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

ABSTRACT 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 · 3.74 Impact Factor