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Antifungal Prophylaxis in Children Receiving Antineoplastic Chemotherapy

  • Pediatric Fungal Infections (E Roilides, Section Editor)
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Abstract

Purpose of the review

The purpose of this study was to summarize data on available antifungal prophylaxis of invasive fungal disease (IFD) in children and when it should be administered during antineoplastic chemotherapy.

Recent findings

Antifungal prophylaxis should be considered when incidence of IFD is ≥ 10%, as acute myeloblastic leukemia, high-risk acute lymphoblastic leukemia, and second-line therapy for any relapsing leukemia. In absence of specific pediatric studies, data from adults indicate that triazoles, especially posaconazole tablets, could represent the most attractive option, even if some troubles (mainly regarding drug interactions and intestinal absorption) must be underlined. Echinocandins and liposomal amphotericin B (intravenous or nebulized) can represent alternatives in specific conditions. Other infection control measures (hand hygiene, respiratory masks) can represent adjunctive and effective measures.

Summary

Antifungal prophylaxis should be implemented in children receiving aggressive chemotherapy for acute leukemia, and triazoles represent the first choice for this purpose.

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Authors and Affiliations

  1. Infectious Diseases Unit, Istituto Giannina Gaslini, Via G.Gaslini, 5, 16147, Genoa, Italy

    Elio Castagnola

  2. Infectious Diseases Unit, DISSal, University of Genoa, Ospedale Policlinico San Martino–IRCCS per l’Oncologia, Genoa, Italy

    Alessio Mesini

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Correspondence to Elio Castagnola.

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Elio Castagnola has received personal fees from Astellas Pharma and Basilea Pharmaceutica. Alessio Mesini declares no conflict of interest.

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This article is part of the Topical Collection on Pediatric Fungal Infections

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Castagnola, E., Mesini, A. Antifungal Prophylaxis in Children Receiving Antineoplastic Chemotherapy. Curr Fungal Infect Rep 12, 78–85 (2018). https://doi.org/10.1007/s12281-018-0311-3

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