Division of Pediatric Hematology and Oncology, Department of Hematology, Spirito Santo Hospital, Via Fonte Romana, Pescara, Italy.
Eur J Pediatr. 2013 Apr;172(4):437-46. doi: 10.1007/s00431-012-1758-9. Epub 2012 Jun 1.
Invasive fungal infections are a common problem in children affected by primary or secondary immunodeficiencies. Thanks to an increased knowledge about their mechanisms of action and their pharmacokinetic and toxicity profiles, the use of these drugs in common and uncommon invasive infections in immunocompromised children has improved over the last decades. Choosing the most appropriate antifungal drug is a serious challenge for any clinician, also considering that, in most cases, therapy has to be started before cultures are available, the choice being driven by clinical symptoms and statistical criteria only. In this study, we performed a systematic review of literature, providing antifungal treatment recommendations for paediatric patients which can help clinicians find the most suitable treatment for each specific case. Principal antifungal drugs-ranging from first-generation antimycotics to the latest molecules-are classified according to their targets, and of each group, the pharmacokinetic profile, clinical indications and side effects are extensively described.
侵袭性真菌感染是原发性或继发性免疫缺陷儿童的常见问题。由于对其作用机制以及药代动力学和毒性特征有了更多的了解，过去几十年来，这些药物在免疫功能低下儿童的常见和不常见侵袭性感染中的应用得到了改善。对于任何临床医生来说，选择最合适的抗真菌药物都是一个严峻的挑战，特别是在大多数情况下，在获得培养结果之前就必须开始治疗，而选择只能基于临床症状和统计标准。在这项研究中，我们对文献进行了系统回顾，为儿科患者提供了抗真菌治疗建议，以帮助临床医生为每个具体病例找到最合适的治疗方法。根据作用靶点，将主要抗真菌药物（从第一代抗真菌药物到最新的分子）进行分类，并且对每组药物的药代动力学特征、临床适应证和副作用都进行了详细描述。
