Abstract
Clinical pharmacology of fluconazole in infants and children
Highlights
Fluconazole is commonly used both to prevent and to treat invasive Candida albicans
Fluconazole is active against several Candida species, Blastomyces dermatitis, Human capsulatum, and Coccidioides species, Paracoccidioides brasiliensis, and ringworm fungi
Fluconazole is active against Aspergillus species, Scedosporium apiospermun (Pseudallescheria boydii), Fusarium, and Sporothrix schenckii, but these fungi are intermediate in susceptibility
Summary
Fluconazole is commonly used both to prevent and to treat invasive Candida albicans. This antibiotic is a potent, selective, triazole-inhibitor of the fungal enzymes involved in ergosterol synthesis. Fluconazole is reasonably effective against most Candida species, other than Candida glabrata It is of value in treatment of Cryptococcal infection. There is no good reason to give amphotericin B as well has high-dose fluconazole, but there is evidence that effective treatment of all Candida species, with MIC of ≤ 8 μg/ml, requires a higher-dose than much reference text currently quote. Oral fluconazole is widely used to treat superficial, topic, infection in adults and is starting to be used for this purpose in infants. While high-dose systemic exposure, such as 400 mg daily in the first trimester of pregnancy can produce a constellation of serious foetal abnormalities there are, as yet, no reports of teratogenicity with a single 150 mg daily-dose in the first trimester, or with topical or oral use later in pregnancy For Candida infection of the breast, the mother should take 100 to 300 mg loading dose and 100 to 200 mg daily for at least ten days. Treat the infant as well and take steps to minimize the risk of re-infection [1]
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