Invasive Fungal Infections While on Voriconazole, Liposomal Amphotericin B, or Micafungin for Antifungal Prophylaxis in Pediatric Stem Cell Transplant Patients.

Author: 

Bui A, Nguyen V, Hsu C, Hyde B, Simms-Waldrip T.
J Pediatr Pharmacol Ther. 2019 May-Jun;24(3):220-226

Abstract: 

OBJECTIVE:

This study aimed to report the incidence of invasive fungal infections (IFIs) in pediatric hematopoietic stem cell transplant (HSCT) patients who received voriconazole, liposomal amphotericin B (L-AMB), or micafungin for primary antifungal prophylaxis (PAP).

METHODS:

Using data retrospectively collected from institution's electronic records, this study analyzed the incidence of IFIs in pediatric HSCT patients between November 2012 and November 2016.

RESULTS:

A total of 103 patients were screened. Of the 84 patients who met inclusion criteria, 76.2%, 29.8%, and 19% patients received voriconazole, L-AMB, and micafungin, respectively. The incidence of overall IFIs was 2.08 per 1000 prophylaxis days. There were 2 mold infections identified in 2 patients. Among 3 antifungal agents, the rates of IFIs were 2.67 per 1000 prophylaxis days in L-AMB group, 2.08 per 1000 prophylaxis days in micafungin group, and 1.17 per 1000 prophylaxis days in voriconazole group.

CONCLUSION:

Patients who received L-AMB or micafungin had higher rates of IFIs than those who received voriconazole for PAP.

KEYWORDS:

antifungal prophylaxis; invasive fungal infection; liposomal amphotericin B; micafungin; voriconazole