Universität zu Köln

Doering, Michaela, Mueller, Carsten, Johann, Pascal-David, Erbacher, Annika, Kimmig, Astrid, Schwarze, Carl-Philipp, Lang, Peter, Handgretinger, Rupert and Mueller, Ingo (2012). Analysis of posaconazole as oral antifungal prophylaxis in pediatric patients under 12 years of age following allogeneic stem cell transplantation. BMC Infect. Dis., 12. LONDON: BIOMED CENTRAL LTD. ISSN 1471-2334

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Abstract

Background: Pediatric patients undergoing hematopoietic stem cell transplantation (HSCT) are at high risk of acquiring fungal infections. Antifungal prophylaxis shortly after transplantation is therefore indicated, but data for pediatric patients under 12 years of age are scarce. To address this issue, we retrospectively assessed the safety, feasibility, and initial efficacy of prophylactic posaconazole in children. Methods: 60 consecutive pediatric patients with a median age of 6.0 years who underwent allogeneic HSCT between August 2007 and July 2010 received antifungal prophylaxis with posaconazole in the outpatient setting. 28 pediatric patients received an oral suspension at 5 mg/kg body weight b.i.d., and 32 pediatric patients received the suspension at 4 mg/kg body weight t.i.d. The observation period lasted from start of treatment with posaconazole until its termination (maximum of 200 days post-transplant). Results: Pediatric patients who received posaconazole at 4 mg/kg body weight t.i.d. had a median trough level of 383 mu g/L. Patients who received posaconazole at 5 mg/kg body weight b.i.d. had a median trough level of 134 mu g/L. Both regimens were well tolerated without severe side effects. In addition, no proven or probable invasive mycosis was observed. Conclusion: Posaconazole was a well-tolerated, safe, and effective oral antifungal prophylaxis in pediatric patients who underwent high-dose chemotherapy and HSCT. Posaconazole at a dosage of 12 mg/kg body weight divided in three doses produced consistently higher morning trough levels than in patients who received posaconazole 5 mg/kg body weight b.i.d. Larger prospective trials are needed to obtain reliable guidelines for antifungal prophylaxis in children after HSCT.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Doering, Michaela UNSPECIFIED UNSPECIFIED UNSPECIFIED Mueller, Carsten UNSPECIFIED UNSPECIFIED UNSPECIFIED Johann, Pascal-David UNSPECIFIED UNSPECIFIED UNSPECIFIED Erbacher, Annika UNSPECIFIED UNSPECIFIED UNSPECIFIED Kimmig, Astrid UNSPECIFIED UNSPECIFIED UNSPECIFIED Schwarze, Carl-Philipp UNSPECIFIED UNSPECIFIED UNSPECIFIED Lang, Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Handgretinger, Rupert UNSPECIFIED UNSPECIFIED UNSPECIFIED Mueller, Ingo UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-480934
DOI:	10.1186/1471-2334-12-263
Journal or Publication Title:	BMC Infect. Dis.
Volume:	12
Date:	2012
Publisher:	BIOMED CENTRAL LTD
Place of Publication:	LONDON
ISSN:	1471-2334
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language INVASIVE FUNGAL-INFECTION; VERSUS-HOST-DISEASE; SAFETY; PHARMACOKINETICS; ASPERGILLOSIS; FLUCONAZOLE; NEUTROPENIA; RECIPIENTS; EFFICACY Multiple languages Infectious Diseases Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/48093