Analysis of posaconazole as oral antifungal prophylaxis in pediatric patients under 12 years of age following allogeneic stem cell transplantation
| Autor: | Carsten Müller, Ingo Müller, Astrid Kimmig, Pascal-David Johann, Rupert Handgretinger, Michaela Döring, Annika Erbacher, Carl-Philipp Schwarze, Peter Lang |
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| Jazyk: | angličtina |
| Předmět: |
Antifungal
Male medicine.medical_specialty Posaconazole Antifungal Agents medicine.drug_class medicine.medical_treatment Pediatric patients Hematopoietic stem cell transplantation Chemoprevention lcsh:Infectious and parasitic diseases Immunocompromised Host Internal medicine medicine Humans lcsh:RC109-216 Child Posaconazole trough levels Retrospective Studies Chemotherapy business.industry Stem cell transplantation Infant Retrospective cohort study Triazoles Surgery Transplantation Treatment Outcome Infectious Diseases Mycoses Child Preschool Trough level Female Stem cell Antifungal prophylaxis business medicine.drug Research Article |
| Zdroj: | BMC Infectious Diseases, Vol 12, Iss 1, p 263 (2012) BMC Infectious Diseases |
| ISSN: | 1471-2334 |
| DOI: | 10.1186/1471-2334-12-263 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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