Kandida Enfeksiyonu Olan Çocuklarda Mikafungin Tedavisinin Klinik Analizi: Tek Merkez Deneyimi

Abstract

Objective: For the treatment of invasive candidiasis (IC) which is confirmed or suspected in adults, echinocandins are usually recommended. In children; however, very little is known about using echinocandins for IC management. Micafungin (MCFG) is approved for both treatment and prevention (prophylaxis) of invasive Candida infections. In this study, pediatric patients diagnosed with Candida infection and treated with MCFG were evaluated retrospectively. Clinical characteristics of the patients and the results of MCFG treatment were discussed in light of the literature. Material and Methods: The study included 10 pediatric patients aged between 28 days and 16 years. They were diagnosed with Candida infection between January 01, 2017 and January 01, 2019, and were treated with MCFG. The patients’ microbiological and laboratory data, demographic and clinical characteristics, risk factors for IC, MCFG treatment characteristics and the side effects were recorded retrospectively from electronic records. Results: The median age of the patients in the study was 22 months (range 1.5 to 178 mo). Candida species isolated from the patients were C. parapsilosis, C. orthopsilosis, C. tropicalis, C. albicans, C. kefyr and C. guilliermondii. The most common underlying disease was gastrointestinal anomaly and related problems. The most common risk factors included the use of broad-spectrum antibiotics, total parenteral nutrition, mechanical ventilation, and central venous catheter. The median dose of MCFG was 2 mg/ kg per day (d) and was applied to the patients for a minimum of 3 days and a maximum of 23 days. There were no side effects observed. Conclusion: In our limited case series of pediatric patients, MCFG was found effective in treating both proven and suspected invasive Candida infections and no adverse side effects were observed.