Posaconazole for Prophylaxis of Fungal Infection in Pediatric Patients with Acute Myeloid Leukemia undergoing Induction Chemotherapy.
10.24304/kjcp.2018.28.3.181
- Author:
Seung Min KIM
1
;
Yoon Sun REE
;
Jae Song KIM
;
Soo Hyun KIM
;
Eun Sun SON
;
Chuhl Joo LYU
Author Information
1. Department of Pharmacy, Severance Hospital, Yon-sei University Health System, Seoul 03722, Republic of Korea. sespharm@yuhs.ac
- Publication Type:Original Article
- Keywords:
Posaconazole;
antifungal prophylaxis;
pediatrics;
acute myeloid leukemia
- MeSH:
Anti-Bacterial Agents;
Antifungal Agents;
Electronic Health Records;
Fever;
Humans;
Incidence;
Induction Chemotherapy*;
Intensive Care Units;
Leukemia, Myeloid, Acute*;
Pediatrics;
Prospective Studies;
Retrospective Studies;
Tablets
- From:Korean Journal of Clinical Pharmacy
2018;28(3):181-187
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Posaconazole is a broad-spectrum triazole antifungal agent and the most recommended prophylactic antifungal agent for patients with acute myeloid leukemia (AML) undergoing induction chemotherapy. In this study, we evaluated the status and effectiveness of posaconazole as a prophylactic antifungal agent in pediatric patients receiving induction chemotherapy for AML. METHODS: We retrospectively reviewed the electronic medical records of 36 pediatric patients with AML (between January 2013 and September 2017) at the Yonsei University Health System. Invasive fungal disease (IFD) was assessed as the primary endpoint of prophylactic antifungal effect. The secondary endpoints were incidence of fever, persistent fever despite the use of broad-spectrum antibiotics for 72 h, alteration of antifungal agent, intensive care unit admission, and death within 100 days. RESULTS: Among the 36 patients, 18 patients used posaconazole, 12 were treated with suspension formula, and 6 of them were treated with tablets. Eighteen patients did not use antifungal agents prophylactically. The mean number of days of posaconazole administration was 26.8±16 days. IFD occurred in 2/18 (11.1%) patients in the no prophylaxis group and in 1/18 (5.6%) patients in the posaconazole group (p=0.49). CONCLUSION: Posaconazole is expected to be useful for the prevention of IFD in pediatric patients with AML undergoing induction chemotherapy. Prospective studies of the effectiveness of posaconazole prophylaxis should be conducted in more pediatric patients in the future.
