Document Detail


Triazole use in the nursery: fluconazole, voriconazole, posaconazole, and ravuconazole.
MedLine Citation:
PMID:  22935068     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Invasive fungal infections in infants admitted to the neonatal intensive care unit are common and often fatal. The mainstay of therapy against invasive fungal infections is antifungal agents. Over the last two decades, the development and approval of these drugs evolved tremendously, and the azole class emerged as important agents in the treatment and prevention of invasive fungal infections. Among the azoles, fluconazole has been used extensively due to its favorable pharmacokinetics, excellent activity against Candida spp, and safety profile. This drug has been well studied in children, but data for its use in infants are largely limited to Candida prophylaxis studies. Voriconazole, a second generation triazole, has excellent activity against Candida and Aspergillus spp. However, data on its use in neonates are extremely limited. Posaconazole and ravuconazole are the newest agents of the triazole family. The antimicrobial spectrum of posaconazole is similar to voriconazole, but with additional activity against zygomycetes. Experience with posaconazole in children is very limited, and there are no reports of its use in infants. Ravuconazole is not approved for use by the FDA, but studies in animals and humans show that it is often fungicidal and has favorable pharmacokinetics. In conclusion, the management of invasive fungal infections has progressed greatly over the last two decades with the azole antifungals playing a significant role. Related to this class, future research is needed in order to better assess dosing, safety, schedules and areas of use of these agents in infants admitted to the neonatal intensive care unit.
Authors:
Kevin Watt; Paolo Manzoni; Michael Cohen-Wolkowiez; Stefano Rizzollo; Elena Boano; Evelyne Jacqz-Aigrain; Daniel K Benjamin
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Review    
Journal Detail:
Title:  Current drug metabolism     Volume:  14     ISSN:  1875-5453     ISO Abbreviation:  Curr. Drug Metab.     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-02-26     Completed Date:  2013-08-09     Revised Date:  2014-02-04    
Medline Journal Info:
Nlm Unique ID:  100960533     Medline TA:  Curr Drug Metab     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  193-202     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Antifungal Agents / pharmacology,  therapeutic use*
Extracorporeal Membrane Oxygenation
Humans
Infant, Newborn
Mycoses / drug therapy*
Triazoles / pharmacology,  therapeutic use*
Grant Support
ID/Acronym/Agency:
1K23HD064814-01/HD/NICHD NIH HHS; 1K24HD058735-01/HD/NICHD NIH HHS; 1R01FD003519-01/FD/FDA HHS; 1R01HD057956-02/HD/NICHD NIH HHS; 1U10-HD45962-06/HD/NICHD NIH HHS; 5T32HD043029-09/HD/NICHD NIH HHS; HHSN275201000003I/HD/NICHD NIH HHS; K23 HD064814/HD/NICHD NIH HHS; K24 HD058735/HD/NICHD NIH HHS; R01 HD057956/HD/NICHD NIH HHS; T32 HD043029/HD/NICHD NIH HHS; U10 HD045962/HD/NICHD NIH HHS
Chemical
Reg. No./Substance:
0/Antifungal Agents; 0/Triazoles
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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