Antifungal therapy in infants and children with proven, probable or suspected invasive fungal infections

Abstract

Limited paediatric data are available comparing antifungal agents in children with proven, probable or suspected invasive fungal infection. No differences in mortality or treatment efficacy were observed when antifungal agents were compared. Children are less likely to develop nephrotoxicity with a lipid preparation of amphotericin B compared with conventional amphotericin B. Further comparative paediatric antifungal drug trials and epidemiological and pharmacological studies are required highlighting the differences between neonates, children and adults with invasive fungal infections.

Systematic review on efficacy and safety of empirical versus pre‐emptive antifungal therapy among children with febrile neutropenia reveals paucity of data

“…Out of the included studies, Blyth et al (2010) was a Cochrane review of seven trials on the effects of different antifungal therapies in children with proven, probable or suspected invasive fungal infections. However, it did not compare the empirical versus pre‐emptive 29 . Seven other studies were excluded because they were conducted in adults, 30–36 did not meet the inclusion criteria.…”

Systematic review on efficacy and safety of empirical versus pre‐emptive antifungal therapy among children with febrile neutropenia reveals paucity of data

“…Out of the included studies, Blyth et al (2010) was a Cochrane review of seven trials on the effects of different antifungal therapies in children with proven, probable or suspected invasive fungal infections. However, it did not compare the empirical versus pre‐emptive 29 . Seven other studies were excluded because they were conducted in adults, 30–36 did not meet the inclusion criteria.…”

The Burden of Neonatal Invasive Candidiasis in Low- and Middle-income Countries: A Systematic Review and Meta-analysis

“…However, population-based studies have demonstrated that the distribution of these species varies between geographical regions [ 40 ]. In children and neonates, whereas C albicans remains the most prevalent species, C parapsilosis , C tropicalis [ 15 , 41–43 ] and, in certain settings, C auris are becoming more common [ 9 , 22 ]. Despite the lack of temporal trends and exhibiting regional variations, our findings have demonstrated that non- albicans species were more prevalent than C albicans in LMICs.…”

Pediatric Antifungal Prescribing Patterns Identify Significant Opportunities to Rationalize Antifungal Use in Children

“…Fung et al 7 published a meta-analysis comparing empirical and preemptive antifungal therapy in adult patients with high-risk febrile neutropenia and reported decreased antifungal use without increasing mortality and no major economic impact when the latter strategy was used. A Cochrane review published in 2015 reported insufficient data to support a preemptive approach in children, 30 and this still remains an important research gap. In the meantime, 2 single-center studies have been published supporting the use of a preemptive approach in children with febrile neutropenia.…”

Systematic review on efficacy and safety of empirical versus pre‐emptive antifungal therapy among children with febrile neutropenia reveals paucity of data

“…Out of the included studies, Blyth et al (2010) was a Cochrane review of seven trials on the effects of different antifungal therapies in children with proven, probable or suspected invasive fungal infections. However, it did not compare the empirical versus pre‐emptive 29 . Seven other studies were excluded because they were conducted in adults, 30–36 did not meet the inclusion criteria.…”

The Burden of Neonatal Invasive Candidiasis in Low- and Middle-income Countries: A Systematic Review and Meta-analysis

“…However, population-based studies have demonstrated that the distribution of these species varies between geographical regions [ 40 ]. In children and neonates, whereas C albicans remains the most prevalent species, C parapsilosis , C tropicalis [ 15 , 41–43 ] and, in certain settings, C auris are becoming more common [ 9 , 22 ]. Despite the lack of temporal trends and exhibiting regional variations, our findings have demonstrated that non- albicans species were more prevalent than C albicans in LMICs.…”

Pediatric Antifungal Prescribing Patterns Identify Significant Opportunities to Rationalize Antifungal Use in Children

“…Fung et al 7 published a meta-analysis comparing empirical and preemptive antifungal therapy in adult patients with high-risk febrile neutropenia and reported decreased antifungal use without increasing mortality and no major economic impact when the latter strategy was used. A Cochrane review published in 2015 reported insufficient data to support a preemptive approach in children, 30 and this still remains an important research gap. In the meantime, 2 single-center studies have been published supporting the use of a preemptive approach in children with febrile neutropenia.…”

Systematic review on efficacy and safety of empirical versus pre‐emptive antifungal therapy among children with febrile neutropenia reveals paucity of data

“…Out of the included studies, Blyth et al (2010) was a Cochrane review of seven trials on the effects of different antifungal therapies in children with proven, probable or suspected invasive fungal infections. However, it did not compare the empirical versus pre‐emptive 29 . Seven other studies were excluded because they were conducted in adults, 30–36 did not meet the inclusion criteria.…”

The Burden of Neonatal Invasive Candidiasis in Low- and Middle-income Countries: A Systematic Review and Meta-analysis

“…However, population-based studies have demonstrated that the distribution of these species varies between geographical regions [ 40 ]. In children and neonates, whereas C albicans remains the most prevalent species, C parapsilosis , C tropicalis [ 15 , 41–43 ] and, in certain settings, C auris are becoming more common [ 9 , 22 ]. Despite the lack of temporal trends and exhibiting regional variations, our findings have demonstrated that non- albicans species were more prevalent than C albicans in LMICs.…”

Pediatric Antifungal Prescribing Patterns Identify Significant Opportunities to Rationalize Antifungal Use in Children

“…Fung et al 7 published a meta-analysis comparing empirical and preemptive antifungal therapy in adult patients with high-risk febrile neutropenia and reported decreased antifungal use without increasing mortality and no major economic impact when the latter strategy was used. A Cochrane review published in 2015 reported insufficient data to support a preemptive approach in children, 30 and this still remains an important research gap. In the meantime, 2 single-center studies have been published supporting the use of a preemptive approach in children with febrile neutropenia.…”