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Posaconazole in immunocompromised pediatric patients
Edoardo Bruno Vicenzi1, Simone Cesaro1
1a Pediatric Hematology Oncology , Azienda Ospedaliera Universitaria Integrata , Verona , Italy.
Expert Review of Anti-Infective Therapy
|June 19, 2018
Summary
Posaconazole is safe and effective for treating fungal infections in children. Dosing and drug monitoring are key to optimizing its effectiveness in pediatric patients.
Area of Science:
- Mycology
- Pediatric Pharmacology
- Infectious Diseases
Background:
- Posaconazole, a broad-spectrum triazole antifungal, is widely used in adults.
- Its off-label use in pediatric patients is common, but pediatric pharmacokinetics, safety, and efficacy require further investigation.
Purpose of the Study:
- To review pediatric studies on posaconazole use from 2010-2017.
- To analyze the correlation between oral dose, plasma levels, safety, and effectiveness in children.
- To provide expert commentary on optimizing posaconazole therapy in pediatric populations.
Main Methods:
- Systematic review of pediatric studies published between 2010 and 2017.
- Analysis of prophylactic and therapeutic use of posaconazole.
- Evaluation of factors affecting absorption, safety, and efficacy.
Main Results:
- Posaconazole is well-tolerated in children with a low incidence of adverse effects.
- Absorption is influenced by gastric pH, mucositis, and drug interactions.
- No direct correlation exists between daily dose and trough plasma concentration due to saturable absorption.
Conclusions:
- Posaconazole is safe and effective for fungal infections in immunocompromised children.
- Body-weight-based dosing and therapeutic drug monitoring are recommended.
- Further research on new posaconazole formulations in children is needed.
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