The disposition of ABLC in neonates was similar to that observed in other age groups: weight was the only factor that influenced clearance. Based on these results and previously published safety and efficacy data, we recommend a daily dosage between 2.5 and 5.0 mg/kg for treatment of invasive Candida infections in neonates.Invasive Candida infections are important causes of infectious morbidity and mortality in premature neonates (10,34,36). The reported frequency in very-low-birth-weight infants, the neonatal population at highest risk, is as high as 20%, with a case fatality rate as high as 50% despite the best available treatment (33,41,43). Current therapeutic options with documented antifungal efficacy include amphotericin B deoxycholate (DAMB) alone or in combination with flucytosine, fluconazole, and the small liposomal formulation of amphotericin B (19,23,39). While treatment with DAMB is frequently limited by the compound's inherent nephrotoxicity (6), fluconazole, a generally well-tolerated, highly water-soluble, renally cleared drug, is not always active (40) and accurate dosing is difficult in very premature neonates that often display extreme variations in the extracellular fluid compartment and urinary output (42). Similarly, while liposomal amphotericin B appears to be well tolerated and effective (30,31), no pharmacokinetic data exist for neonates and dosing is therefore still determined by maximally tolerated dosages. For these reasons, there clearly is a need for improved, pharmacokinetically based antifungal therapies in neonates with invasive Candida infections.Amphotericin B lipid complex (ABLC) is a unique lipid formulation and is composed of dimiristoyl phosphatidylcholin/dimiristoyl phospatidylglycerol in a 1:1 molar ratio of lipid to amphotericin B and forms large ribbon-like structures. Following intravenous administration, ABLC is rapidly and efficiently taken up by cells of the mononuclear phagocytic system, mainly of the liver, spleen, and lungs, resulting in a larger volume of distribution (V) than that of conventional DAMB but a lower peak maximum concentration of the drug in the serum and lower values in the blood for the area under the concentration-time curve (25,27). Based on a series of large, open-label, noncomparative clinical trials (44, 46), ABLC was approved by the Food and Drug Administration for the treatment of adult and pediatric patients with invasive fungal infections who are intolerant of or refractory to DAMB therapy. In addition, a prospective, randomized multicenter trial in 231 patients Ն16 years of age with invasive Candida infections has demonstrated that a dosage of 5 mg/kg of ABLC was less nephrotoxic and as effecitve as DAMB at a dosage of 0.6 to 1.0 mg/kg of body weight (WT) (E. J.

Understanding the role that children play in the clinical burden and propagation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) responsible for novel coronavirus (COVID-19) infections is emerging. While the severe manifestations and acute clinical burden of COVID-19 has largely spared children compared to adults, understanding the epidemiology, clinical presentation, diagnostics, management, and prevention opportunities as well as the social and behavioral impacts on child health is vital. Foremost is clarifying the contribution of asymptomatic and mild infections to transmission within the household and community and the clinical and epidemiologic significance of uncommon severe post-infectious complications. Herein we summarize the current knowledge, identify useful resources, and outline research opportunities. Pediatric infectious disease clinicians have a unique opportunity to advocate for the inclusion of children in epidemiological, clinical, treatment and prevention studies to optimize their care, as well as to represent children in the development of guidance and policy during pandemic response.

Complications occurred commonly in children receiving OPAT and resulted in unplanned medical visits.

A cerebrospinal fluid pleocytosis is relatively common in hospitalized infants <6 months of age who have a UTI and usually does not reflect bacterial meningitis. Knowledge of this may prevent unnecessary courses of antibiotics for presumed bacterial meningitis and lead to evaluation for other possible causes of aseptic meningitis including viral or congenital infections.