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posaconazol in children's

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https://www.readbyqxmd.com/read/29367872/photoletter-to-the-editor-atypical-primary-cutaneous-mucormycosis-of-the-scalp
#1
Ricardo García-Sepúlveda, Josefina Navarrete-Solís, Hiram Villanueva-Lozano, Rogelio de J Treviño-Rangel, Gloria M González, Jorge Enríquez-Rojas, Javier Molina-Durazo, Roberto Arenas-Guzmán
Mucormycosis of the scalp is a rare cutaneous presentation of the disease. It is also an unusual infection in children. We present the case of a 4-year-old girl with acute lymphoblastic leukemia, who presented with atypical cutaneous mucormycosis simulating an ecthyma gangrenosum lesion. Risk factors for the infection are diabetes, neoplastic diseases, immunosuppression in organ transplant recipients, and neutropenia. The cutaneos forms have been associated with trauma, burns and surgical wounds. First line treatment is amphotericin B...
December 1, 2017: Journal of Dermatological Case Reports
https://www.readbyqxmd.com/read/29337457/-pharmacovigilance-update
#2
Françoise Livio
The main pharmacovigilance updates in 2017 are reviewed. Denosumab : rebound-associated multiple vertebral fractures after discontinuation. Canagliflozine: increased risk of foot/leg amputations. Biologic and targeted cancer therapies, direct-acting antivirals for chronic hepatitis C: risk of hepatitis B reactivation. Checkpoint inhibitors : immune-related adverse events and graft rejection. Fingolimod : rebound-associated reactivation of MS following withdrawal. Daclizumab: risk of severe liver injury leading to restricted use in MS patients...
January 10, 2018: Revue Médicale Suisse
https://www.readbyqxmd.com/read/29240266/posaconazole-oral-dose-and-plasma-levels-in-pediatric-hematology-oncology-patients
#3
Edoardo Bruno Vicenzi, Elisabetta Calore, Nunzia Decembrino, Massimo Berger, Katia Perruccio, Francesca Carraro, Sara Rossin, Maria Caterina Putti, Mariadelfina Molinaro, Gloria Tridello, Simone Cesaro
BACKGROUND: Posaconazole is a triazole with limited pharmacokinetic information in children. This study assessed the correlation between posaconazole-oral-solution daily dosage/kg/body weight and trough plasma level. METHODS: 97 hematology-oncology pediatric patients with > 1 posaconazole plasma level (PPC) assessment in the first 6 weeks after the start of posaconazole treatment were included. RESULTS: Posaconazole was used as prophylaxis in 84 of 97 (87%) patients and as therapy in 13 of 97 (13%)...
December 14, 2017: European Journal of Haematology
https://www.readbyqxmd.com/read/29219892/toxicity-of-vincristine-combined-with-posaconazole-in-children-with-acute-lymphoblastic-leukemia
#4
Esra Pekpak, Talia İleri, Elif İnce, Mehmet Ertem, Zümrüt Uysal
BACKGROUND: Vincristine (VCR) is one of the main drugs of acute lymphoblastic leukemia (ALL) treatment. Azole antifungal medications are used for treatment or prophylaxis of invasive fungal infections in acute leukemia. Coadministration of these drugs increases the risk of VCR toxicity. OBSERVATIONS: We presented a girl with ALL using posaconazole prophylaxis. She developed VCR toxicity that included tubulopathy, high blood pressure, neuropathic pain, difficulty walking, diffuse muscular weakness, constipation, abdominal pain...
December 6, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/29155163/antifungal-azoles-itraconazole-and-posaconazole-exhibit-potent-in-vitro-antiviral-activity-against-clinical-isolates-of-parechovirus-a3-picornaviridae
#5
Eric Rhoden, W Allan Nix, William C Weldon, Rangaraj Selvarangan
Parechovirus A3 (Par-A3, formerly human parechovirus 3) is an emerging viral infection of the central nervous system in children. We used an automated, homogeneous, cell based assay to identify itraconazole and posaconazole as inhibitors of Par-A3, with antiviral activity below concentrations clinically attainable in pediatric patients. Currently, there is no approved antiviral treatment for Par-A3 infection, despite numerous reports of serious Par-A3 disease in neonates and infants.
November 15, 2017: Antiviral Research
https://www.readbyqxmd.com/read/28186550/posaconazole-plasma-monitoring-in-immunocompromised-children
#6
Jessica McMahon, Yves Théorêt, Julie Autmizguine, Henrique Bittencourt, Bruce Tapiéro, Philippe Ovetchkine
Plasma posaconazole exposure was assessed in 13 children who underwent a hematopoietic stem cell transplant. The median dosage was 12.5 mg/kg per day, divided into 3 doses. Of these 13 patients, 46.2% (6) and 30.8% (4) achieved concentrations higher than 0.7 and 1.25 mg/L, respectively. In children at high risk, a higher dosage might be needed to achieve target concentrations.
February 10, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/27982447/therapeutic-drug-monitoring-of-posaconazole-oral-suspension-in-paediatric-patients-younger-than-13-years-of-age-a-retrospective-analysis-and-literature-review
#7
T Jancel, P A Shaw, C W Hallahan, T Kim, A F Freeman, S M Holland, S R Penzak
WHAT IS KNOWN AND OBJECTIVE: Posaconazole is an extended-spectrum triazole antifungal with activity against a variety of clinically significant yeasts and moulds. Posaconazole is not currently approved by the U.S. Food and Drug Administration for use in children younger than 13 years of age. Our primary objective was to describe the dosing and observed trough concentrations with posaconazole oral suspension in paediatric patients at the National Institutes of Health Clinical Center (Bethesda, MD)...
February 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/26544987/pharmacokinetics-of-posaconazole-oral-suspension-in-children-dosed-according-to-body-surface-area
#8
Kim Vanstraelen, Anca Colita, Ana Maria Bica, Raf Mols, Patrick Augustijns, Nele Peersman, Pieter Vermeersch, Pieter Annaert, Isabel Spriet
BACKGROUND: Antifungal prophylaxis remains challenging in immunocompromised children as no clear consensus has yet been reached about which drug to be used. Posaconazole has a broad spectrum of activity, a favorable safety profile and excellent prophylactic activity in adults. However, a lack of pharmacokinetic studies in pediatric patients hampers routine implementation. This study investigates the pharmacokinetics of a newly introduced posaconazole dosing regimen based on the body surface area in pediatric hematologic patients...
February 2016: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/26398542/posaconazole-use-in-the-prophylaxis-and-treatment-of-fungal-infections
#9
REVIEW
Nina M Clark, Shellee A Grim, Joseph P Lynch
Posaconazole, a fluorinated triazole antifungal drug, is approved by the U.S. Food and Drug Administration (FDA) for (1) prophylaxis against Aspergillus and Candida infections in immunocompromised patients at high risk for these infections and (2) oropharyngeal candidiasis (OPC), including cases refractory to fluconazole and/or itraconazole. The European Medicines Agency (EMA) has approved posaconazole for (1) treatment of aspergillosis, fusariosis, chromoblastomycosis, and coccidioidomycosis in patients who are refractory to or intolerant of other azoles or amphotericin B; (2) first-line therapy for OPC for severe disease or in those unlikely to respond to topical therapy; and (3) prophylaxis of invasive fungal infections in high-risk hematologic patients and stem cell transplant recipients...
October 2015: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/26216395/magnetic-resonance-imaging-assessment-of-the-ventricular-system-in-the-brains-of-adult-and-juvenile-beagle-dogs-treated-with-posaconazole-iv-solution
#10
C D G Hines, X Song, S Kuruvilla, G Farris, C G Markgraf
INTRODUCTION: Noxafil® (posaconazole; POS) is a potent, selective triazole antifungal approved for use in adults as an oral suspension, oral tablet and intravenous (IV) Solution. In support of pediatric administration of POS IV Solution to children<two years of age, a nonclinical study in juvenile pre-weaning Beagle dogs was conducted, which showed enlarged lateral ventricles in the brain at the conclusion of a 6 week dosing period. METHODS: To evaluate the impact of this finding on older age dogs, which would support administration to children>two years of age, two studies were undertaken using magnetic resonance imaging (MRI) to monitor brain ventricle size longitudinally during three months administration of POS IV in adult and juvenile dogs...
November 2015: Journal of Pharmacological and Toxicological Methods
https://www.readbyqxmd.com/read/25973938/posaconazole-promising-but-problematic-in-practice-in-pediatric-patients
#11
REVIEW
Amanda Gwee, Noel Cranswick, Nigel Curtis
Posaconazole is a broad-spectrum antifungal agent used for the prevention and treatment of invasive fungal infections. It is currently only licensed for use in children greater than 12 years of age. Absorption of the oral formulation is unpredictable and affected by mucositis and concomitant medications. We reviewed studies of posaconazole use in children younger than 12 years in relation to attainment of target serum concentrations.
June 2015: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/25913290/management-of-invasive-fungal-infections-in-pediatric-acute-leukemia-and-the-appropriate-time-for-restarting-chemotherapy
#12
Özlem Tüfekçi, Şebnem Yılmaz Bengoa, Fatma Demir Yenigürbüz, Erdem Şimşek, Tuba Hilkay Karapınar, Gülersu İrken, Hale Ören
OBJECTIVE: Rapid and effective treatment of invasive fungal infection (IFI) in patients with leukemia is important for survival. In this study, we aimed to describe variations regarding clinical features, treatment modalities, time of restarting chemotherapy, and outcome in children with IFI and acute leukemia (AL). MATERIALS AND METHODS: The charts of all pediatric AL patients in our clinic between the years of 2001 and 2013 were retrospectively reviewed. All patients received prophylactic fluconazole during the chemotherapy period...
December 2015: Turkish Journal of Haematology: Official Journal of Turkish Society of Haematology
https://www.readbyqxmd.com/read/25512681/anti-fungal-resistance-in-candida-isolated-from-oral-and-diaper-rash-candidiasis-in-neonates
#13
Jasem Mohamadi, Mahsa Motaghi, Jafar Panahi, Mohamad Reza Havasian, Ali Delpisheh, Mitra Azizian, Iraj Pakzad
The purpose of the present study is to evaluate the sensitivity of Candida species isolated from oral candidiasis and diaper dermatitis infections in children. The children referring to private and public clinics in Ilam, Iran were exmined for oral candidiasis and diaper dermatitis. In this study, 248 oral candidiasis and diaper dermatitis samples were collected and cultured.Candida species were identified by using standard methods. Resistance and sensitivity to amphotericin B, nystatin, ketoconazole, fluconazole, itraconazole, clotrimazole, and posaconazole were determined using the CLSI M44-A standard disk diffusion method...
2014: Bioinformation
https://www.readbyqxmd.com/read/25492394/in-vitro-antifungal-susceptibility-of-trichophyton-violaceum-isolated-from-tinea-capitis-patients
#14
S Deng, G S de Hoog, P E Verweij, J Zoll, M Ilkit, F Morsali, P Abliz, X Wang, P Zhan, L Yang, H Hasimu, W Liao, W Pan, S Seyedmousavi
OBJECTIVES: Trichophyton violaceum is an anthropophilic dermatophyte that is endemic to parts of Africa and Asia and is sporadic in Europe. T. violaceum mainly causes tinea capitis in both children and adolescents. Although the infections caused by T. violaceum are of considerable medical importance, its antifungal susceptibility profile remains poorly examined. METHODS: In this study, we tested the in vitro antifungal susceptibility of a set of clinical T. violaceum isolates obtained from tinea capitis patients, using the CLSI broth microdilution method...
April 2015: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/24762093/fungemia-in-a-spanish-hospital-the-role-of-candida-parapsilosis-over-a-15-year-period
#15
Mar Martí-Carrizosa, Ferran Sánchez-Reus, Francesca March, Pere Coll
BACKGROUND: Candida parapsilosis is one of the main causes of fungemia in tertiary-care hospitals. Few studies have analysed the changes in its distribution over a long period. We compared the distribution of C. parapsilosis with that of other fungi over a 15-y period in a tertiary hospital. METHODS: The susceptibility of C. parapsilosis was analysed using the new species-specific clinical breakpoints. The C. parapsilosis complex species were differentiated molecularly...
June 2014: Scandinavian Journal of Infectious Diseases
https://www.readbyqxmd.com/read/24595533/pharmacokinetics-and-pharmacodynamics-of-antifungals-in-children-and-their-clinical-implications
#16
REVIEW
Chris Stockmann, Jonathan E Constance, Jessica K Roberts, Jared Olson, Elizabeth H Doby, Krow Ampofo, Justin Stiers, Michael G Spigarelli, Catherine M T Sherwin
Invasive fungal infections are a significant cause of morbidity and mortality in children. Successful management of these systemic infections requires identification of the causative pathogen, appropriate antifungal selection, and optimisation of its pharmacokinetic and pharmacodynamic properties to maximise its antifungal activity and minimise toxicity and the emergence of resistance. This review highlights salient scientific advancements in paediatric antifungal pharmacotherapies and focuses on pharmacokinetic and pharmacodynamic studies that underpin current clinical decision making...
May 2014: Clinical Pharmacokinetics
https://www.readbyqxmd.com/read/24479848/escmid-and-ecmm-joint-clinical-guidelines-for-the-diagnosis-and-management-of-mucormycosis-2013
#17
O A Cornely, S Arikan-Akdagli, E Dannaoui, A H Groll, K Lagrou, A Chakrabarti, F Lanternier, L Pagano, A Skiada, M Akova, M C Arendrup, T Boekhout, A Chowdhary, M Cuenca-Estrella, T Freiberger, J Guinea, J Guarro, S de Hoog, W Hope, E Johnson, S Kathuria, M Lackner, C Lass-Flörl, O Lortholary, J F Meis, J Meletiadis, P Muñoz, M Richardson, E Roilides, A M Tortorano, A J Ullmann, A van Diepeningen, P Verweij, G Petrikkos
These European Society for Clinical Microbiology and Infectious Diseases and European Confederation of Medical Mycology Joint Clinical Guidelines focus on the diagnosis and management of mucormycosis. Only a few of the numerous recommendations can be summarized here. To diagnose mucormycosis, direct microscopy preferably using optical brighteners, histopathology and culture are strongly recommended. Pathogen identification to species level by molecular methods and susceptibility testing are strongly recommended to establish epidemiological knowledge...
April 2014: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/24294271/breakthrough-filamentous-fungal-infections-in-pediatric-hematopoetic-stem-cell-transplant-and-oncology-patients-receiving-caspofungin
#18
Shaun K Morris, Upton D Allen, Sumit Gupta, Susan E Richardson
BACKGROUND: Caspofungin is an echinocandin class antifungal medication that is commonly used empirically in immunocompromised patients at high risk for invasive fungal disease. OBJECTIVE: To describe the clinical characteristics of breakthrough fungal infections in pediatric hematopoetic stem cell transplant recipients, and oncology and hematology patients receiving caspofungin. METHODS: A five-year retrospective review, from 2004 through 2008, of all cases of proven invasive filamentous fungal infection of children admitted to The Hospital for Sick Children (Toronto, Ontario) was conducted...
2012: Canadian Journal of Infectious Diseases & Medical Microbiology
https://www.readbyqxmd.com/read/24209593/candidiasis-oropharyngeal
#19
REVIEW
Caroline L Pankhurst
INTRODUCTION: Candida is a fungus present in the mouths of up to 60% of healthy people, but overt infection is associated with immunosuppression, diabetes, broad-spectrum antibiotics, and corticosteroid use. In most people, untreated candidiasis persists for months or years unless associated risk factors are treated or eliminated. In neonates, spontaneous cure of oropharyngeal candidiasis usually occurs after 3 to 8 weeks. METHODS AND OUTCOMES: We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of interventions to prevent and treat oropharyngeal candidiasis in: adults undergoing treatments that cause immunosuppression; infants and children; people with dentures; and people with HIV infection? Which antifungal treatments reduce the risk of acquiring resistance to antifungal drugs? We searched: Medline, Embase, The Cochrane Library, and other important databases up to July 2013 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review)...
2013: Clinical Evidence
https://www.readbyqxmd.com/read/24198097/azole-based-chemoprophylaxis-of-invasive-fungal-infections-in-paediatric-patients-with-acute-leukaemia-an-internal-audit
#20
Sara Yunus, Stephanie Pieper, Hedwig Kolve, Grazyna Goletz, Heribert Jürgens, Andreas H Groll
OBJECTIVES: Children and adolescents with acute myeloid leukaemia (AML) and recurrent acute leukaemias (RALs) are at high risk of life-threatening invasive fungal infections (IFIs). We analysed implementation, safety and efficacy of a standard operating procedure for oral, azole-based, mould-active antifungal prophylaxis. METHODS: Patients with AML and RALs aged ≥13 years received 200 mg of posaconazole three times daily and patients aged 2-12 years received 200 mg of voriconazole two times daily from the completion of chemotherapy until haematopoietic recovery...
March 2014: Journal of Antimicrobial Chemotherapy
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