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Antifungal combinations in paediatric invasive fungal infections: a protocol for systematic review and meta-analysis

Roy Novri Ramadhan1,2, Derren David Christian Homenta Rampengan3, Felicia Angelica Gunawan3

  • 1Faculty of Medicine, Airlangga University, Surabaya, Indonesia.

BMJ Open
|October 30, 2024
PubMed
Abstract

Insights

This systematic review evaluates combination antifungal therapies for paediatric invasive fungal infections (IFIs). It aims to clarify efficacy and safety in immunocompromised children, particularly those with blood cancers.

Area of Science:

  • Paediatric Infectious Diseases
  • Clinical Pharmacy
  • Systematic Review and Meta-Analysis

Background:

  • Invasive fungal infections (IFIs) pose significant risks to immunocompromised children, leading to high morbidity and mortality.
  • Current antifungal treatments' efficacy and safety in paediatric populations, especially those with haematological malignancies, require further investigation.
  • Combination antifungal therapies are increasingly used, but their role in paediatric IFIs remains debated.

Purpose of the Study:

  • To systematically review and meta-analyze the efficacy and safety of combination antifungal therapies in paediatric patients with IFIs.
  • To compare combination antifungal treatments against placebo or monotherapy in this vulnerable population.
  • To provide evidence-based guidance for optimizing antifungal strategies in paediatric IFIs.

Main Methods:

  • Comprehensive literature search across major databases (PubMed, ScienceDirect, Cochrane Library, BMJ, Springer) from inception to present.
  • Inclusion of randomized controlled trials and observational studies on combination antifungal therapies in patients under 18 years with IFIs.
  • Data management and analysis using COVIDENCE, with rigorous quality assessment and statistical integrity.

Main Results:

  • The review will synthesize data on response rates, survival, and mortality associated with combination antifungal therapies.
  • Adverse effects, cost-effectiveness, and quality of life impacts will be critically evaluated.
  • Statistical analysis will determine the overall efficacy and safety profile of antifungal combinations.

Conclusions:

  • Findings will inform clinical practice regarding the use of combination antifungal therapies in paediatric IFIs.
  • The study aims to guide healthcare professionals in tailoring treatment for better outcomes in immunocompromised children.
  • Results will contribute to evidence-based guidelines for managing paediatric invasive fungal infections.
Keywords:
drug combinations

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