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Rhizopus Infection in a Preterm Infant: A Novel Use of Posaconazole

Roxana Fatemizadeh1, Emily Rodman1,2, Gail J Demmler-Harrison1

  • 1From the Department of Pediatrics, Baylor College of Medicine, Houston, Texas.

The Pediatric Infectious Disease Journal
|February 22, 2020
PubMed

Insights

This case study reports the successful treatment of a preterm infant with Rhizopus infection using combination antifungal therapy including enteral posaconazole. It marks the first documented use of posaconazole in a preterm neonate for this specific fungal infection.

Area of Science:

  • Mycology
  • Neonatal Medicine
  • Pharmacology

Background:

  • Data on the use and pharmacokinetics of posaconazole in preterm infants are limited.
  • Rhizopus infections pose a significant threat to vulnerable neonates.
  • Posaconazole is a triazole antifungal agent with known activity against Rhizopus species.

Observation:

  • A neonate born at 24 4/7 weeks gestation developed a Rhizopus infection.
  • The infant was treated with surgical debridement and a combination antifungal regimen.
  • The regimen included amphotericin B, micafungin, and enteral posaconazole.

Findings:

  • The combination antifungal therapy, including enteral posaconazole, was successful in treating the Rhizopus infection.
  • This case represents the first reported instance of posaconazole administration to a preterm neonate with Rhizopus.
  • The successful outcome suggests potential efficacy of posaconazole in this population.

Implications:

  • This case provides valuable preliminary data on the use of posaconazole in extremely preterm infants.
  • Further research is warranted to establish optimal dosing and pharmacokinetic profiles of posaconazole in neonates.
  • The findings may inform treatment strategies for invasive fungal infections in critically ill preterm infants.

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