title: Antifungal agents in children.
abstract: Fungal pathogens are an increasingly recognized complication of organ transplantation and the ever more potent chemotherapeutic regimens for childhood malignancies. This article provides a brief overview of the current state of systemic antifungal therapy. Currently licensed drugs, including amphotericin B and its lipid derivates; 5-fluorocytosine; the azoles, including fluconazole, itraconazole, and voriconazole; and a representative of the new class of echinocandin agents, caspofungin, are discussed. Newer second-generation azoles (posaconazole and ravuconazole) and echinocandins (micafungin and anidulafungin) that are likely to be licensed in the United States in the next few years also are addressed.
authors.affiliation: Department of Pediatrics, Division of Pediatric Infectious Diseases, Duke University Medical Center, Durham, NC 27710, USA. stein002@mc.duke.edu
authors.forename: William J
authors.initials: WJ
authors.lastname: Steinbach
mesh_terms: D000367:Age Factors; D000666:Amphotericin B / Q000627:therapeutic use; D000077612:Anidulafungin; D000935:Antifungal Agents / Q000737:chemistry / Q000494:pharmacology / Q000600:supply & distribution / Q000627:therapeutic use*; D000077336:Caspofungin; D002626:Chemistry, Pharmaceutical; D002648:Child; D002986:Clinical Trials as Topic; D017277:Drug Approval; D025141:Drug Resistance, Fungal; D054714:Echinocandins; D015725:Fluconazole / Q000627:therapeutic use; D005437:Flucytosine / Q000627:therapeutic use; D006801:Humans; D017964:Itraconazole / Q000627:therapeutic use; D055666:Lipopeptides; D008074:Lipoproteins / Q000627:therapeutic use; D000077551:Micafungin; D009181:Mycoses / Q000188:drug therapy* / Q000382:microbiology; D018579:Patient Selection; D010372:Pediatrics / Q000379:methods* / Q000592:standards / Q000639:trends; D010456:Peptides, Cyclic / Q000627:therapeutic use; D011743:Pyrimidines / Q000627:therapeutic use; D012449:Safety; D013844:Thiazoles / Q000627:therapeutic use; D014230:Triazoles / Q000627:therapeutic use; D014481:United States; D065819:Voriconazole
chemical_list: D000935:Antifungal Agents; D054714:Echinocandins; D055666:Lipopeptides; D008074:Lipoproteins; D010456:Peptides, Cyclic; D011743:Pyrimidines; D013844:Thiazoles; D014230:Triazoles; D017964:Itraconazole; C101425:posaconazole; D000666:Amphotericin B; D015725:Fluconazole; C104066:ER 30346; D000077612:Anidulafungin; D005437:Flucytosine; D000077336:Caspofungin; D065819:Voriconazole; D000077551:Micafungin