Antifungal Therapy in Pediatric Patients

Abstract

Invasive fungal infections still play a major role in morbidity and mortality in pediatric patients, especially in children undergoing therapy for an underlying malignancy and in preterm infants. Relative to the adult population, pediatric age groups display important differences not only in host biology, predisposing conditions, epidemiology, and presentation of fungal infections, but also in the disposition and clearance of antifungal compounds. During the past decade, several new antifungal agents have been developed. Although not all of these agents are yet approved for children, the pediatric development of antifungal agents has moved forward in an exemplary manner, which is essential for the successful management of the individual patient. This article reviews the current data on pharmacokinetics, safety, and dosing of antifungal agents in pediatric patients.

Treatment Principles for the Management of Mold Infections

“…Finally, the pharmacokinetic behavior and optimal dosing strategy for echinocandins and triazoles in pediatrics (Lehrnbecher et al 2011), the morbidly obese (Pai and Bearden 2007;Pai and Lodise 2011), or critically ill septic patients (Hoenigl et al 2013) are still being defined. Even in the absence of these conditions, the considerable pharmacokinetic variability of voriconazole and posaconazole makes it almost impossible to predict the likely range of drug exposure ( plasma levels), even when doses are administered on a mg/kg basis (Andes et al 2008).…”