An Overview of Advances in the Treatment of Mycoses in Pediatric Patients

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An Overview of Advances in the Treatment of Mycoses in Pediatric Patients

January 5, 2021 Microbiology and Biotechnology 0

Excessive morbidity and mortality in paediatrics are significant causes of invasive fungal infections (IFIs). There are different variables that can increase the risk in paediatrics of developing an IFI. The key indications for the administration of antifungal drugs in paediatrics are checked, as well as an update of the antifungal agent evidence and the antifungal policies carried out. Specifically, in three main areas, antifungal treatment is revised as follows: (a) premature neonate prophylaxis against invasive candidiasis; (b) candidemia and meningoencephalitis control in neonates; and (c) in children with primary or secondary immunodeficiencies, prophylaxis, empirical treatment and targeted antifungal therapy. The most popular antifungal prophylactic agent prescribed to high-risk neonates and children remains Fluconazole. However, during preventive or empirical therapy, the emergence of fluconazole resistance, especially in non-albicans of the Candida genus, should be considered. While fluconazole is used as an antifungal prophylaxis in neonatal intensive care units (NICU’s) with a relatively high incidence of invasive candidiasis (IC), its position is under continuous debate in very low birth-weight neonates. The key therapy for treating neonatal and paediatric yeast and mould infections remains amphotericin B, mainly in its liposomal formulation. Except for mucormycosis in children > 2 years of age, Voriconazole is indicated for mould infections. New triazoles, such as posaconazole and isavuconazole, and echinocandins are either approved or under review for first-line or rescue therapy, while in refractory situations, combination therapy is maintained.

Author(s) Details

Dr. Elias Iosifidis
Infectious Diseases Unit, 3rd Department of Pediatrics, Faculty of Medicine, Aristotle University School of Health Sciences, Konstantinoupoleos 49, 54642 Thessaloniki, Greece.

Savvas Papachristou
Infectious Diseases Unit, 3rd Department of Pediatrics, Faculty of Medicine, Aristotle University School of Health Sciences, Konstantinoupoleos 49, 54642 Thessaloniki, Greece.

Emmanuel Roilides
Infectious Diseases Unit, 3rd Department of Pediatrics, Faculty of Medicine, Aristotle University School of Health Sciences, Konstantinoupoleos 49, 54642 Thessaloniki, Greece.

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