Updates in the Pharmacologic Prophylaxis and Treatment of Invasive Candidiasis in the Pediatric and Neonatal Intensive Care Units: Updates in the Pharmacologic Prophylaxis.
Updates in the Pharmacologic Prophylaxis and Treatment of Invasive Candidiasis in the Pediatric and Neonatal Intensive Care Units: Updates in the Pharmacologic Prophylaxis.
复制标题
DOI：
10.1007/s40506-022-00258-z
复制
发表时间：
2022-06
影响因子：
2
通讯作者：
Stultz, Jeremy S
中科院分区：
文献类型：
--
作者：
Fly, James Hunter;Kapoor, Seerat;Bobo, Kelly;Stultz, Jeremy S
本综述的目的是提供新生儿重症监护病房(NICU)和儿科重症监护病房(PICU)侵袭性念珠菌病(IC)的预防和治疗方案的最新进展。研究进一步验证了在NICU的高危患者中使用氟康唑预防IC。目前尚不清楚预防是否会导致耐药性的产生，理想的给药方案也不清楚。最近发表的研究将卡泊芬净和米卡芬净与两性霉素B进行了比较，并说明了在NICU中类似的疗效结果。Micafungin现在已获得美国食品和药物管理局(FDA)的批准，可用于4个月大的婴儿。PICU的预防策略可能包括锌和维生素D。Anidulafungin最近有非比较数据支持对1个月以上的儿童患者使用，最近FDA也批准对1个月及以上的儿童使用。氟康唑预防仍然是选择NICU患者的合理策略，尽管还需要进一步的耐药性分析和最佳给药方案。棘球绦虫是新生儿和儿童人群中非脑膜炎或尿路感染的潜在治疗选择。
The goal of this review was to provide an update on the prevention and treatment options for invasive candidiasis (IC) in the neonatal intensive care unit (NICU) and pediatric intensive care unit (PICU). Studies have further validated the use of fluconazole for IC prophylaxis among high-risk patients in the NICU. It remains unclear if prophylaxis leads to resistance development and the ideal dosage regimen is still not clear. Recent studies have been published comparing caspofungin and micafungin to amphotericin B and illustrated similar efficacy outcomes in the NICU. Micafungin now has approval from the United States Food and Drug Administration (FDA) for use in infants < 4 months of age. Prophylactic strategies in the PICU could include zinc and vitamin D. Anidulafungin has recent non-comparative data supporting use in pediatric patients older than 1 month of age and also has a recent FDA approval for use in children 1 month of age and older. Fluconazole prophylaxis remains a reasonable strategy in select NICU patients, although further analyses of resistance and the optimal dosage regimen are needed. Echinocandins are potential therapeutic options for non-meningitis or urinary tract infections in both the neonatal and pediatric population.