Abstract
Invasive fungal infections (IFI) are an important complication in pediatric haematological and oncological patients who undergo intensive chemotherapy for leukemia, solid tumour at advanced stage or relapsed, and hematopoietic stem cell transplantation. The incidence of IFI is lower than bacterial infection but mortality rate remains high. This review is designed to help paediatric oncologists in choosing the appropriate anti-fungal strategy and agents for prophylaxis, empirical, pre-emptive and specific therapy on the basis of published evidence.
Highlights
Azienda Ospedaliera di Perugia; 3Pediatric Hematology Oncology, Azienda Ospedaliera Universitaria Integrata, mortality
2011 ly Abstract on Invasive fungal infections (IFI) are an important complication in pediatric haematoe logical and oncological patients who undergo s intensive chemotherapy for leukemia, solid u tumour at advanced stage or relapsed, and l hematopoietic stem cell transplantation
The ia incidence of IFI is lower than bacterial infection but mortality rate remains high. This c review is designed to help paediatric oncolor gists in choosing the appropriate anti-fungal e strategy and agents for prophylaxis, empirical, pre-emptive and specific therapy on the basis m of published evidence. com Introduction n- Despite the advent of advanced anti-fungal o agents, invasive fungal infections (IFI) remain N a major cause of morbidity and mortality in Regarding empirical therapy a recent metaanalysis indicated that this strategy reduced significantly the incidence of proven and probable IFI in neutropenic patients but it was not able to reduce overall mortality.[9]
Summary
Grading C III or relapsing solid tumours when local epidemi- Ninane J, Fluconazole 3 mg/kg vs IFI: 2.1% in Fluconazole group; C II ology data show an incidence of IFI higher 1994 than usually reported in other centres or high-. Nystatin 50.000 U/kg or oral 8.4% in Amphotericin B group Amphotericin B 25 mg/kg/die er than in a recent past. 1 mg/Kg 2 times/week vs early 5 probable; active, in analyzed studies, were fluconazole intervention. 1 possible; and itraconazole, liposomal amphotericin-B, and recently micafungin. C II or other azoles are used.[5] or Fluconazole 5-8mg/kg/die IFI: 2 proven; Differently from prophylaxis, the empiric if toxicity. 27 possible use of antifungal drugs has been investigated Kolve H, 2009 84 in prospective controlled randomized studies
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