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Antifungal prophylaxis in pediatric patients undergoing therapy for cancer: drugs and dosing

Thomas Lehrnbecher1

  • 1Division of Pediatric Hematology and Oncology, Hospital for Children and Adolescents, Johann Wolfgang Goethe-University, Frankfurt, Germany.

Current Opinion in Infectious Diseases
|September 19, 2015
PubMed
Abstract

Insights

Antifungal prophylaxis is widely used in immunocompromised children, but optimal dosing requires further study. Future research should focus on establishing the best drug dosages to prevent invasive fungal disease (IFD) in pediatric patients.

Area of Science:

  • Pediatric Infectious Diseases
  • Pharmacology
  • Immunocompromised Patient Care

Background:

  • Invasive fungal disease (IFD) significantly impacts morbidity and mortality in immunocompromised patients.
  • Pediatric antifungal pharmacokinetics and pharmacodynamics are less understood compared to adults.
  • Many effective adult antifungal agents lack pediatric licensing.

Purpose of the Study:

  • To review current literature on antifungal prophylaxis drugs and dosing in pediatric patients.
  • To address the knowledge gap in pediatric antifungal therapy.
  • To inform clinical practice regarding antifungal prophylaxis in children.

Main Methods:

  • Systematic literature review of studies on antifungal prophylaxis in pediatric populations.
  • Analysis of available data on drug safety and efficacy in children.
  • Extrapolation of evidence from adult studies where pediatric data is limited.

Main Results:

  • Limited approved antifungal prophylaxis options exist for children.
  • Existing reports suggest safety and potential efficacy of various agents.
  • Evidence for efficacy often relies on extrapolation from adult data due to small pediatric study sizes.
  • Optimal dosage for balancing efficacy and toxicity remains largely unaddressed.

Conclusions:

  • Antifungal prophylaxis is extensively used in pediatric patients.
  • Further research is crucial to establish optimal dosing strategies for each antifungal agent in children.
  • Standardizing pediatric antifungal prophylaxis requires robust clinical trials.

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