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Invasive fungal infections in infants-focus on anidulafungin

Michael H Wilke1

  • 1Dr. Wilke GmbH, inspiring.health, Munich, Germany.

Clinical Medicine Insights. Pediatrics
|May 4, 2013
PubMed
Abstract

Insights

Invasive fungal infections in pediatric intensive care units (PICU) are increasing. Anidulafungin shows a good safety profile and pharmacodynamics for treating these infections in children.

Area of Science:

  • Pediatric critical care medicine
  • Mycology
  • Infectious diseases

Background:

  • Invasive fungal infections (IFIs) pose a growing threat in pediatric intensive care units (PICUs).
  • Candida species are the most common pathogens, with increasing resistance to fluconazole.
  • Echinocandins are considered for treatment, but guidelines suggest their use only after fluconazole or Amphotericin B failure or contraindication.

Purpose of the Study:

  • To review the literature on IFIs in PICU settings.
  • To examine the role and efficacy of anidulafungin in treating pediatric invasive candidiasis.

Main Methods:

  • A literature search was conducted on PubMed for articles published between 2000 and 2012.
  • Articles were categorized into reviews, pharmacokinetic/pharmacodynamic (PK/PD) studies, and case reports.
  • A total of 14 relevant articles were selected from 67 search results.

Main Results:

  • Anidulafungin demonstrated a favorable safety profile in PK/PD studies, with no serious adverse events reported.
  • Key risk factors for IFIs in PICU include central venous catheters, antibiotic use, parenteral nutrition, and neutropenia.
  • Echinocandins, particularly micafungin, show promise due to their safety, but further trials are needed.

Conclusions:

  • Limited literature exists on anidulafungin in PICUs, but available data show good PK/PD dynamics and safety.
  • Anidulafungin dosing in infants (0.75-1.5 mg/kg/day) appears effective, comparable to adult doses.
  • Further clinical trials are recommended to evaluate anidulafungin in real-world PICU and NICU settings.
Keywords:
NICUPICUanidulafunginantifungal therapyechinocandinsinfantsneonatal intensive care unitpediatric intensive care unitreview

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