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Role of echinocandins in the management of fungal infections in neonates.

Publication ,  Journal Article
Manzoni, P; Rizzollo, S; Franco, C; Gallo, E; Galletto, P; Boano, E; Mostert, M; Benjamin, DK; Jacqz-Aigrain, E; Farina, D
Published in: J Matern Fetal Neonatal Med
October 2010

As the incidence rates of neonatal systemic fungal infections (SFI) have been increasing over the last years, research efforts have been addressed towards identifying both effective preventative strategies, and efficacious and well-tolerated antifungal drugs. Historically, the first options in treatment of neonatal SFI have been – and currently are – fluconazole and amphotericin B. However, these two drugs carry limitations both in efficacy and in putative toxicity. Recently, new therapeutic alternatives have drawn the neonatologists' attention. Echinocandins are a new class of antifungal drugs with characteristics that might better meet the needs of this particular population of patients. Caspofungin (CSP), micafungin (MICA), and anidulafungin have inherent good activities both against biofilms, and against natively fluconazole-resistant strains of Candida spp, thus overcoming two of the major weaknesses of the commonly used antifungal drugs in nurseries. CSP and MICA have been recently studied in neonatal populations. The kinetics and appropriate dosing of this agent in premature and term infants have been described, but ongoing further studies are needed to better address this area. Case-report series show clinical efficacy and tolerability in critical neonatal patients given CSP and MICA. In addition, extrapolation of data from randomized trials conducted in pediatric and adult patients showed through a subgroup analysis that both CSP and MICA are effective and well tolerated also in neonates. Further studies properly designed for neonatal populations will better address long-term safety and ecological issues related to echinocandin use in neonates.

Duke Scholars

Published In

J Matern Fetal Neonatal Med

DOI

EISSN

1476-4954

Publication Date

October 2010

Volume

23 Suppl 3

Start / End Page

49 / 52

Location

England

Related Subject Headings

  • Obstetrics & Reproductive Medicine
  • Mycoses
  • Infant, Premature
  • Infant, Newborn, Diseases
  • Infant, Newborn
  • Humans
  • Echinocandins
  • Child
  • Antifungal Agents
  • 4204 Midwifery
 

Citation

APA
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MLA
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Manzoni, P., Rizzollo, S., Franco, C., Gallo, E., Galletto, P., Boano, E., … Farina, D. (2010). Role of echinocandins in the management of fungal infections in neonates. J Matern Fetal Neonatal Med, 23 Suppl 3, 49–52. https://doi.org/10.3109/14767058.2010.509914
Manzoni, Paolo, Stefano Rizzollo, Caterina Franco, Elena Gallo, Paolo Galletto, Elena Boano, Michael Mostert, Daniel K. Benjamin, Evelyne Jacqz-Aigrain, and Daniele Farina. “Role of echinocandins in the management of fungal infections in neonates.J Matern Fetal Neonatal Med 23 Suppl 3 (October 2010): 49–52. https://doi.org/10.3109/14767058.2010.509914.
Manzoni P, Rizzollo S, Franco C, Gallo E, Galletto P, Boano E, et al. Role of echinocandins in the management of fungal infections in neonates. J Matern Fetal Neonatal Med. 2010 Oct;23 Suppl 3:49–52.
Manzoni, Paolo, et al. “Role of echinocandins in the management of fungal infections in neonates.J Matern Fetal Neonatal Med, vol. 23 Suppl 3, Oct. 2010, pp. 49–52. Pubmed, doi:10.3109/14767058.2010.509914.
Manzoni P, Rizzollo S, Franco C, Gallo E, Galletto P, Boano E, Mostert M, Benjamin DK, Jacqz-Aigrain E, Farina D. Role of echinocandins in the management of fungal infections in neonates. J Matern Fetal Neonatal Med. 2010 Oct;23 Suppl 3:49–52.

Published In

J Matern Fetal Neonatal Med

DOI

EISSN

1476-4954

Publication Date

October 2010

Volume

23 Suppl 3

Start / End Page

49 / 52

Location

England

Related Subject Headings

  • Obstetrics & Reproductive Medicine
  • Mycoses
  • Infant, Premature
  • Infant, Newborn, Diseases
  • Infant, Newborn
  • Humans
  • Echinocandins
  • Child
  • Antifungal Agents
  • 4204 Midwifery