Scholarlink

Purpose of Review <p>Invasive fungal diseases (IFDs) represent a significant cause of morbidity and mortality in the pediatric population, particularly in neonates and immunocompromised children. This narrative review aims to summarize the clinical conditions associated with opportunistic IFDs in pediatrics and to provide an updated overview of the indications, drugs, and strategies for primary antifungal prophylaxis.</p> Recent Findings <p>While <i>Candida</i> and <i>Aspergillus</i> species remain the primary threats, emerging pathogens such as <i>Candida auris</i> and rare molds (e.g., <i>Fusarium</i>, <i>Lomentospora</i>, <i>Scedosporium</i>) are increasingly reported. Advances in neonatal care have solidified the role of fluconazole prophylaxis in very-low-birth-weight infants, while new data support the use of echinocandins (micafungin and caspofungin) in specific high-risk cohorts, such as neonates with <i>C. auris</i> exposure or pediatric acute myeloid leukemia. Furthermore, the emergence of small molecule targeted therapies and the increasing use of aggressive immunosuppression for autoimmune disorders present new, though less defined, risks for IFD.&#xa0;</p> Summary <p>Primary antifungal prophylaxis is a cornerstone in the management of high-risk pediatric patients, including preterm neonates, children with specific primary immunodeficiencies (e.g., chronic granulomatous disease), and those undergoing intensive chemotherapy or hematopoietic stem cell transplantation. The selection of antifungal agents must account for age-related pharmacokinetics, potential drug-drug interactions, and local resistance patterns. Effective prevention requires an integrated approach combining pharmacological prophylaxis—often supported by therapeutic drug monitoring—with rigorous environmental controls and hand hygiene to mitigate the risk of fungal exposure.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Prophylaxis of Invasive Fungal Infections in Pediatric Patients: A Narrative Review

  • 期刊论文

  • 发表日期：

    2026年4月22日

查看全文
  • Elio Castagnola,
  • Martina Toto,
  • Bianca Monti,
  • Lorenzo Crupi

摘要

Purpose of Review

Invasive fungal diseases (IFDs) represent a significant cause of morbidity and mortality in the pediatric population, particularly in neonates and immunocompromised children. This narrative review aims to summarize the clinical conditions associated with opportunistic IFDs in pediatrics and to provide an updated overview of the indications, drugs, and strategies for primary antifungal prophylaxis.

Recent Findings

While Candida and Aspergillus species remain the primary threats, emerging pathogens such as Candida auris and rare molds (e.g., Fusarium, Lomentospora, Scedosporium) are increasingly reported. Advances in neonatal care have solidified the role of fluconazole prophylaxis in very-low-birth-weight infants, while new data support the use of echinocandins (micafungin and caspofungin) in specific high-risk cohorts, such as neonates with C. auris exposure or pediatric acute myeloid leukemia. Furthermore, the emergence of small molecule targeted therapies and the increasing use of aggressive immunosuppression for autoimmune disorders present new, though less defined, risks for IFD. 

Summary

Primary antifungal prophylaxis is a cornerstone in the management of high-risk pediatric patients, including preterm neonates, children with specific primary immunodeficiencies (e.g., chronic granulomatous disease), and those undergoing intensive chemotherapy or hematopoietic stem cell transplantation. The selection of antifungal agents must account for age-related pharmacokinetics, potential drug-drug interactions, and local resistance patterns. Effective prevention requires an integrated approach combining pharmacological prophylaxis—often supported by therapeutic drug monitoring—with rigorous environmental controls and hand hygiene to mitigate the risk of fungal exposure.