caa a22 4500 606155422 CHVBK 20210128100603.0 cr unu---uuuuu 210128e20150601xx s 000 0 eng 10.1007/s10096-015-2340-y doi (NATIONALLICENCE)springer-10.1007/s10096-015-2340-y Antifungal prophylaxis with posaconazole vs. fluconazole or itraconazole in pediatric patients with neutropenia [Elektronische Daten] [M. Döring, M. Eikemeier, K. Cabanillas Stanchi, U. Hartmann, M. Ebinger, C.-P. Schwarze, A. Schulz, R. Handgretinger, I. Müller] Pediatric patients with hemato-oncological malignancies and neutropenia resulting from chemotherapy have a high risk of acquiring invasive fungal infections. Oral antifungal prophylaxis with azoles, such as fluconazole or itraconazole, is preferentially used in pediatric patients after chemotherapy. During this retrospective analysis, posaconazole was administered based on favorable results from studies in adult patients with neutropenia and after allogeneic hematopoietic stem cell transplantation. Retrospectively, safety, feasibility, and initial data on the efficacy of posaconazole were compared to fluconazole and itraconazole in pediatric and adolescent patients during neutropenia. Ninety-three pediatric patients with hemato-oncological malignancies with a median age of 12years (range 9months to 17.7years) that had prolonged neutropenia (>5days) after chemotherapy or due to their underlying disease, and who received fluconazole, itraconazole, or posaconazole as antifungal prophylaxis, were analyzed in this retrospective single-center survey. The incidence of invasive fungal infections in pediatric patients was low under each of the azoles. One case of proven aspergillosis occurred in each group. In addition, there were a few cases of possible invasive fungal infection under fluconazole (n = 1) and itraconazole (n = 2). However, no such cases were observed under posaconazole. The rates of potentially clinical drug-related adverse events were higher in the fluconazole (n = 4) and itraconazole (n = 5) groups compared to patients receiving posaconazole (n = 3). Posaconazole, fluconazole, and itraconazole are comparably effective in preventing invasive fungal infections in pediatric patients. Defining dose recommendations in these patients requires larger studies. The Author(s), 2015 Döring M. Department I—General Paediatrics, Hematology/Oncology, University Hospital Tuebingen, Children's Hospital, Hoppe-Seyler-Str. 1, 72076, Tuebingen, Germany aut Eikemeier M. Department of Pediatric Hematology and Oncology, University Hospital Ulm, Children's Hospital, Albert-Einstein-Allee 23, 89081, Ulm, Germany aut Cabanillas Stanchi K. Department I—General Paediatrics, Hematology/Oncology, University Hospital Tuebingen, Children's Hospital, Hoppe-Seyler-Str. 1, 72076, Tuebingen, Germany aut Hartmann U. Pharmacy, University Hospital Tuebingen, Children's Hospital, Hoppe-Seyler-Str. 1, 72076, Tuebingen, Germany aut Ebinger M. Department I—General Paediatrics, Hematology/Oncology, University Hospital Tuebingen, Children's Hospital, Hoppe-Seyler-Str. 1, 72076, Tuebingen, Germany aut Schwarze C.-P Department I—General Paediatrics, Hematology/Oncology, University Hospital Tuebingen, Children's Hospital, Hoppe-Seyler-Str. 1, 72076, Tuebingen, Germany aut Schulz A. Department of Pediatric Hematology and Oncology, University Hospital Ulm, Children's Hospital, Albert-Einstein-Allee 23, 89081, Ulm, Germany aut Handgretinger R. Department I—General Paediatrics, Hematology/Oncology, University Hospital Tuebingen, Children's Hospital, Hoppe-Seyler-Str. 1, 72076, Tuebingen, Germany aut Müller I. Clinic of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany aut European Journal of Clinical Microbiology & Infectious Diseases Springer Berlin Heidelberg 34/6(2015-06-01), 1189-1200 0934-9723 34:6<1189 2015 34 10096 https://doi.org/10.1007/s10096-015-2340-y text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10096-015-2340-y text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Döring M. Department I—General Paediatrics, Hematology/Oncology, University Hospital Tuebingen, Children's Hospital, Hoppe-Seyler-Str. 1, 72076, Tuebingen, Germany aut NATIONALLICENCE 700 1- Eikemeier M. Department of Pediatric Hematology and Oncology, University Hospital Ulm, Children's Hospital, Albert-Einstein-Allee 23, 89081, Ulm, Germany aut NATIONALLICENCE 700 1- Cabanillas Stanchi K. Department I—General Paediatrics, Hematology/Oncology, University Hospital Tuebingen, Children's Hospital, Hoppe-Seyler-Str. 1, 72076, Tuebingen, Germany aut NATIONALLICENCE 700 1- Hartmann U. Pharmacy, University Hospital Tuebingen, Children's Hospital, Hoppe-Seyler-Str. 1, 72076, Tuebingen, Germany aut NATIONALLICENCE 700 1- Ebinger M. Department I—General Paediatrics, Hematology/Oncology, University Hospital Tuebingen, Children's Hospital, Hoppe-Seyler-Str. 1, 72076, Tuebingen, Germany aut NATIONALLICENCE 700 1- Schwarze C.-P Department I—General Paediatrics, Hematology/Oncology, University Hospital Tuebingen, Children's Hospital, Hoppe-Seyler-Str. 1, 72076, Tuebingen, Germany aut NATIONALLICENCE 700 1- Schulz A. Department of Pediatric Hematology and Oncology, University Hospital Ulm, Children's Hospital, Albert-Einstein-Allee 23, 89081, Ulm, Germany aut NATIONALLICENCE 700 1- Handgretinger R. Department I—General Paediatrics, Hematology/Oncology, University Hospital Tuebingen, Children's Hospital, Hoppe-Seyler-Str. 1, 72076, Tuebingen, Germany aut NATIONALLICENCE 700 1- Müller I. Clinic of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany aut NATIONALLICENCE 773 0- European Journal of Clinical Microbiology & Infectious Diseases Springer Berlin Heidelberg 34/6(2015-06-01), 1189-1200 0934-9723 34:6<1189 2015 34 10096