Antifungal therapy in children: an update

Area of Science:

• Pediatric Infectious Diseases
• Mycology
• Clinical Pharmacology

Background:

• Invasive fungal infections (IFIs) pose significant risks to children with primary or secondary immunodeficiencies.
• Advances in understanding antifungal drug mechanisms, pharmacokinetics, and toxicity have improved treatment outcomes over recent decades.
• Selecting optimal antifungal therapy for pediatric IFIs is challenging, often requiring empirical treatment before definitive diagnostic data are available.

Purpose of the Study:

• To provide evidence-based antifungal treatment recommendations for pediatric patients with invasive fungal infections.
• To assist clinicians in making informed therapeutic choices for immunocompromised children.
• To systematically review and classify antifungal agents based on their properties and clinical utility.

Main Methods:

• Systematic literature review of antifungal treatments for pediatric invasive fungal infections.
• Classification of antifungal drugs based on their mechanisms of action, from first-generation to newer agents.
• Detailed description of pharmacokinetic profiles, clinical indications, and side effects for each drug class.

Main Results:

• The review categorizes principal antifungal drugs by their molecular targets.
• Comprehensive data on pharmacokinetics, clinical applications, and adverse effects are presented for each antifungal drug group.
• The study synthesizes information to support clinical decision-making in pediatric antifungal therapy.

Conclusions:

• This systematic review provides valuable guidance for managing invasive fungal infections in immunocompromised children.
• The classification and detailed profiles of antifungal agents aim to optimize treatment selection in challenging clinical scenarios.
• Clinicians can utilize these recommendations to improve therapeutic strategies for pediatric patients with IFIs.