Pediatric antifungal therapy. Part I: focus on febrile neutropenia, invasive aspergillosis, combination antifungal therapy and invasive candidiasis in immunocompromised pediatric patients.
The number of available antifungal agents has significantly increased in recent years. These agents are starting to take over niches that were previously occupied by conventional amphotericin B. For many of these agents, pediatric data from randomized trials are generally lacking and clinicians are faced with extrapolating from data generated in adult patients. This notwithstanding, this report summarizes recommendations that define the roles of newer antifungal agents in the treatment of selected scenarios among immunocompromised pediatric patients. The report includes the outcome of a Canadian conference on the use of antifungal agents in children, supplemented by literature reviews and incorporating information from existing national or international guidelines, where appropriate. The focus of the report is on febrile neutropenia, invasive aspergillosis, combination antifungal therapy and selected aspects of the management of invasive candidiasis.
Allen
U
U
Division of Infectious Diseases, Hospital for Sick Children, University of Toronto, ON, Canada. upton.allen@sickkids.ca
Bow
E
E
Doyle
J
J
Richardson
S
S
Robinson
J
J
Rotstein
C
C
Davies
D
D
Hui
C
C
Le Saux
N
N
Laverdiere
M
M
Read
S
S
D000935:Antifungal Agents / Q000627:therapeutic use*; D001228:Aspergillosis / Q000188:drug therapy*; D002177:Candidiasis / Q000188:drug therapy*; D002648:Child; D004359:Drug Therapy, Combination; D005334:Fever / Q000188:drug therapy*; D006801:Humans; D016867:Immunocompromised Host; D009503:Neutropenia / Q000188:drug therapy*
D000935:Antifungal Agents