Analysis of posaconazole as oral antifungal prophylaxis in pediatric patients under 12 years of age following allogeneic stem cell transplantation.
BMC Infect Dis
; 12: 263, 2012 Oct 19.
Article
em En
| MEDLINE
| ID: mdl-23082876
ABSTRACT
BACKGROUND:
Pediatric patients undergoing hematopoietic stem cell transplantation (HSCT) are at high risk of acquiring fungal infections. Antifungal prophylaxis shortly after transplantation is therefore indicated, but data for pediatric patients under 12 years of age are scarce. To address this issue, we retrospectively assessed the safety, feasibility, and initial efficacy of prophylactic posaconazole in children.METHODS:
60 consecutive pediatric patients with a median age of 6.0 years who underwent allogeneic HSCT between August 2007 and July 2010 received antifungal prophylaxis with posaconazole in the outpatient setting. 28 pediatric patients received an oral suspension at 5 mg/kg body weight b.i.d., and 32 pediatric patients received the suspension at 4 mg/kg body weight t.i.d. The observation period lasted from start of treatment with posaconazole until its termination (maximum of 200 days post-transplant).RESULTS:
Pediatric patients who received posaconazole at 4 mg/kg body weight t.i.d. had a median trough level of 383 µg/L. Patients who received posaconazole at 5 mg/kg body weight b.i.d. had a median trough level of 134 µg/L. Both regimens were well tolerated without severe side effects. In addition, no proven or probable invasive mycosis was observed.CONCLUSION:
Posaconazole was a well-tolerated, safe, and effective oral antifungal prophylaxis in pediatric patients who underwent high-dose chemotherapy and HSCT. Posaconazole at a dosage of 12 mg/kg body weight divided in three doses produced consistently higher morning trough levels than in patients who received posaconazole 5 mg/kg body weight b.i.d. Larger prospective trials are needed to obtain reliable guidelines for antifungal prophylaxis in children after HSCT.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Triazóis
/
Hospedeiro Imunocomprometido
/
Quimioprevenção
/
Transplante de Células-Tronco
/
Micoses
/
Antifúngicos
Tipo de estudo:
Guideline
/
Observational_studies
/
Risk_factors_studies
Limite:
Child
/
Child, preschool
/
Female
/
Humans
/
Infant
/
Male
Idioma:
En
Ano de publicação:
2012
Tipo de documento:
Article