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http://dx.doi.org/10.24304/kjcp.2018.28.3.181

Posaconazole for Prophylaxis of Fungal Infection in Pediatric Patients with Acute Myeloid Leukemia undergoing Induction Chemotherapy  

Kim, Seung Min (Department of Pharmacy, Severance Hospital, Yon-sei University Health System)
Ree, Yoon Sun (Department of Pharmacy, Severance Hospital, Yon-sei University Health System)
Kim, Jae Song (Department of Pharmacy, Severance Hospital, Yon-sei University Health System)
Kim, Soo Hyun (Department of Pharmacy, Severance Hospital, Yon-sei University Health System)
Son, Eun Sun (Department of Pharmacy, Severance Hospital, Yon-sei University Health System)
Lyu, Chuhl Joo (Department of Pediatric Hematology Oncology, Severance Hospital, Yon-sei University Health System)
Publication Information
Korean Journal of Clinical Pharmacy / v.28, no.3, 2018 , pp. 181-187 More about this Journal
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 $26.8{\pm}16days$. 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.
Keywords
Posaconazole; antifungal prophylaxis; pediatrics; acute myeloid leukemia;
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