Dhondt F, Ninane J, De Beule K, Dhondt A, Cauwenbergh G
St Norbertus Hospital, Duffel, Belgium.
Mycoses. 1992 Jan-Feb;35(1-2):1-8. doi: 10.1111/j.1439-0507.1992.tb00812.x.
Oral candidosis in neonates and children is a common infection which occurs often during the first few months after birth, but occasionally also in older children with certain predisposing factors. In neonates, oral candidosis is usually benign, although the symptoms of such an acute infection can be disturbing to both the patient and the parents. In older children developing oral candidosis, specific predisposing factors may be present (e.g. immunodeficiency, chemotherapy, etc.). In such cases, the infection may constitute a source for further dissemination, leading to occasionally fatal Candida sepsis or to widespread chronic mucocutaneous candidosis. Treatment modalities to date include drugs with limited or no absorption from the gastrointestinal tract (e.g. nystatin and miconazole) and agents that are absorbed, combining local effect with systemic therapy (e.g. clotrimazole, ketoconazole, itraconazole and fluconazole). Overall, it appears that treatment of neonatal oral candidosis should be performed with non-absorbable drugs, while the systemically active agents should be used primarily if a risk of dissemination exists or if widespread disease is present. In general, side-effects and toxicity are not major causes of concern with non-absorbed or absorbed antifungals in children with oral candidosis, since treatment is usually of relatively short duration. When the systemically active agents are used in premature infants with sub-optimal liver function, the risk of drug-induced liver toxicity may be increased.
新生儿和儿童口腔念珠菌病是一种常见感染，常在出生后的头几个月发生，但在有某些易感因素的大龄儿童中也偶有发生。在新生儿中，口腔念珠菌病通常是良性的，尽管这种急性感染的症状可能会让患儿及其父母感到困扰。在患口腔念珠菌病的大龄儿童中，可能存在特定的易感因素（如免疫缺陷、化疗等）。在这种情况下，感染可能成为进一步播散的源头，偶尔会导致致命的念珠菌败血症或广泛的慢性黏膜皮肤念珠菌病。迄今为止的治疗方式包括胃肠道吸收有限或无吸收的药物（如制霉菌素和咪康唑）以及可吸收的药物，将局部作用与全身治疗相结合（如克霉唑、酮康唑、伊曲康唑和氟康唑）。总体而言，新生儿口腔念珠菌病的治疗似乎应使用不吸收的药物，而如果存在播散风险或患有广泛性疾病，则应主要使用全身活性药物。一般来说，对于患口腔念珠菌病的儿童，未吸收或已吸收的抗真菌药物的副作用和毒性并非主要关注点，因为治疗通常持续时间相对较短。当全身活性药物用于肝功能欠佳的早产儿，药物性肝毒性风险可能会增加。
