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Fluconazole in the treatment of candidiasis in immunocompromised children
C Viscoli1, E Castagnola, F Fioredda
1First Department of Infectious Diseases, University of Genoa, Italy.
Insights
Fluconazole demonstrated high clinical and microbiological success in treating pediatric candidiasis, even in immunocompromised children. This antifungal agent shows promise as an alternative to amphotericin B.
Area of Science:
- Mycology
- Pediatric Infectious Diseases
- Clinical Pharmacology
Background:
- Candidiasis poses a significant risk in children with severe underlying health conditions.
- Established antifungal treatments like amphotericin B have limitations, necessitating exploration of alternatives.
Purpose of the Study:
- To evaluate the efficacy and safety of fluconazole in treating candidiasis in a pediatric population.
- To assess fluconazole's potential as an alternative antifungal agent in children.
Main Methods:
- A pilot study involving 24 children with 34 episodes of candidiasis.
- Administration of fluconazole at 6 mg/kg daily, with a dose increase to 12 mg/kg in two cases.
- Patients had various predisposing conditions including HIV, cancer, and organ transplantation.
Main Results:
- Clinical and microbiological success was observed in 30 out of 34 cases (88%).
- Two patients (6%) experienced drug-related increases in transaminase levels.
- Fluconazole was administered orally or intravenously.
Conclusions:
- Fluconazole appears to be an effective and safe option for treating candidiasis in children, including those with significant comorbidities.
- Further comparative trials are warranted to establish optimal dosing and confirm efficacy against established treatments like amphotericin B.
Abstract:
Fluconazole, a new triazole derivative, was evaluated in a pilot study of 34 episodes of candidiasis in 24 children. All the patients had predisposing conditions, such as human immunodeficiency virus infection, cancer, organ or bone marrow transplantation, neonatal age and malnutrition, and obstructive uropathy. The drug was administered at 6 mg/kg (body weight) once daily either orally or intravenously. Two patients with fungemia due to Candida parapsilosis required an increased dosage of 12 mg/kg. Clinical and microbiological success was achieved in 30 of 34 cases (88%). Drug-related transaminase increases were observed in two cases (6%). Fluconazole may represent an effective alternative to amphotericin B in the treatment of candidiasis in children. Comparative trials are necessary to assess optimal dosages and efficacy.