OBJECTIVE: Prophylaxis with posaconazole (PP) is effective in the prevention of invasive fungal infections in immunocompromised adult patients. However, evaluation of its effectiveness and safety in children is limited. The aim of the study was to describe the use of posaconazole as antifungal prophylaxis in children. METHODS: We reviewed the medical records of immunocompromised patients younger than 13 years with hematologic diseases and post hematopoietic stem cell transplant (HSCT) who received antifungal PP at the Instituto Nacional de Salud del Niño San Borja (INSN-SB) in Lima, Peru, from January 2014 to December 2018. RESULTS: Fifty-six courses of PP were identified in 47 patients with a median age of 7.5 years (IQR, 4-10), 51.6% (n = 24) of whom were female. The main underlying medical conditions were aplastic anemia (n = 19, 33.9%), acute lymphoblastic leukemia (n = 18, 32.1%), acute myeloid leukemia (n = 14, 25.0%), and 34.1% had undergone HSCT. The median dose of posaconazole was 13.62 mg/kg/day (IQR, 12.0-16.8), and the median duration of PP was 24 days (IQR, 16-82). Gastrointestinal symptoms included abdominal pain (17.9%), nausea (16.1%), diarrhea (7.1%), and vomiting (3.6%). Elevated alanine aminotransferase and aspartate aminotransferase levels were observed in 9/35 patients (25.7%) and 10/51 (19.6%) patients, respectively. Five cases of breakthrough fungal infection were identified (8.9%). CONCLUSIONS: Patients younger than 13 years who received PP showed an increase in transaminase values, and the development of breakthrough fungal infections. Copyright. Pediatric Pharmacy Association. All rights reserved. For permissions, email: mhelms@pediatricpharmacy.org 2022.
OBJECTIVE: Prophylaxis with posaconazole (PP) is effective in the prevention of invasive fungal infections in immunocompromised adult patients. However, evaluation of its effectiveness and safety in children is limited. The aim of the study was to describe the use of posaconazole as antifungal prophylaxis in children. METHODS: We reviewed the medical records of immunocompromised patients younger than 13 years with hematologic diseases and post hematopoietic stem cell transplant (HSCT) who received antifungal PP at the Instituto Nacional de Salud del Niño San Borja (INSN-SB) in Lima, Peru, from January 2014 to December 2018. RESULTS: Fifty-six courses of PP were identified in 47 patients with a median age of 7.5 years (IQR, 4-10), 51.6% (n = 24) of whom were female. The main underlying medical conditions were aplastic anemia (n = 19, 33.9%), acute lymphoblastic leukemia (n = 18, 32.1%), acute myeloid leukemia (n = 14, 25.0%), and 34.1% had undergone HSCT. The median dose of posaconazole was 13.62 mg/kg/day (IQR, 12.0-16.8), and the median duration of PP was 24 days (IQR, 16-82). Gastrointestinal symptoms included abdominal pain (17.9%), nausea (16.1%), diarrhea (7.1%), and vomiting (3.6%). Elevated alanine aminotransferase and aspartate aminotransferase levels were observed in 9/35 patients (25.7%) and 10/51 (19.6%) patients, respectively. Five cases of breakthrough fungal infection were identified (8.9%). CONCLUSIONS: Patients younger than 13 years who received PP showed an increase in transaminase values, and the development of breakthrough fungal infections. Copyright. Pediatric Pharmacy Association. All rights reserved. For permissions, email: mhelms@pediatricpharmacy.org 2022.
Authors: M Döring; M Eikemeier; K M Cabanillas Stanchi; U Hartmann; M Ebinger; C-P Schwarze; A Schulz; R Handgretinger; I Müller Journal: Eur J Clin Microbiol Infect Dis Date: 2015-02-14 Impact factor: 3.267
Authors: M Döring; O Blume; S Haufe; U Hartmann; A Kimmig; C-P Schwarze; P Lang; R Handgretinger; I Müller Journal: Eur J Clin Microbiol Infect Dis Date: 2013-10-31 Impact factor: 3.267
Authors: Antonio C Arrieta; Lillian Sung; John S Bradley; C Michel Zwaan; Davis Gates; Hetty Waskin; Patricia Carmelitano; Andreas H Groll; Thomas Lehrnbecher; Eric Mangin; Amita Joshi; Nicholas A Kartsonis; Thomas J Walsh; Amanda Paschke Journal: PLoS One Date: 2019-03-26 Impact factor: 3.240
Authors: Andrew J Ullmann; Martin Schmidt-Hieber; Hartmut Bertz; Werner J Heinz; Michael Kiehl; William Krüger; Sabine Mousset; Stefan Neuburger; Silke Neumann; Olaf Penack; Gerda Silling; Jörg Janne Vehreschild; Hermann Einsele; Georg Maschmeyer Journal: Ann Hematol Date: 2016-06-24 Impact factor: 3.673