Combination antifungals as an effective means of salvage in paediatric leukaemia patients with invasive fungal infections

Indian J Med Microbiol. 2019 Jan-Mar;37(1):109-112. doi: 10.4103/ijmm.IJMM_18_157.

Abstract

Invasive fungal infections (IFIs) are an important cause of morbidity and mortality in paediatric leukaemias. Antifungal combinations to treat these patients are being explored. Fourteen children with leukaemias and IFIs were treated with a combination of antifungal agents at our centre. The first antifungal was amphotericin-B in 13 children and voriconazole in one child. In view of no improvement and clinical deterioration, in nine patients, voriconazole was added as the second antifungal agent and in four, it was caspofungin. All patients completed 4-6 weeks of antifungal therapy. The overall mortality attributable to IFI for the cohort was 4/14 (28%).

Keywords: Combination antifungals; leukaemias; paediatrics.

MeSH terms

  • Adolescent
  • Amphotericin B / therapeutic use*
  • Antifungal Agents / therapeutic use*
  • Caspofungin / therapeutic use*
  • Child
  • Child, Preschool
  • Drug Therapy, Combination
  • Female
  • Fungi / drug effects
  • Humans
  • Invasive Fungal Infections / drug therapy*
  • Leukemia / microbiology
  • Male
  • Retrospective Studies
  • Voriconazole / therapeutic use*

Substances

  • Antifungal Agents
  • Amphotericin B
  • Caspofungin
  • Voriconazole