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Triazole use in the nursery: fluconazole, voriconazole, posaconazole, and ravuconazole.

Publication ,  Journal Article
Watt, K; Manzoni, P; Cohen-Wolkowiez, M; Rizzollo, S; Boano, E; Jacqz-Aigrain, E; Benjamin, DK
Published in: Curr Drug Metab
February 2013

Invasive fungal infections in infants admitted to the neonatal intensive care unit are common and often fatal. The mainstay of therapy against invasive fungal infections is antifungal agents. Over the last two decades, the development and approval of these drugs evolved tremendously, and the azole class emerged as important agents in the treatment and prevention of invasive fungal infections. Among the azoles, fluconazole has been used extensively due to its favorable pharmacokinetics, excellent activity against Candida spp, and safety profile. This drug has been well studied in children, but data for its use in infants are largely limited to Candida prophylaxis studies. Voriconazole, a second generation triazole, has excellent activity against Candida and Aspergillus spp. However, data on its use in neonates are extremely limited. Posaconazole and ravuconazole are the newest agents of the triazole family. The antimicrobial spectrum of posaconazole is similar to voriconazole, but with additional activity against zygomycetes. Experience with posaconazole in children is very limited, and there are no reports of its use in infants. Ravuconazole is not approved for use by the FDA, but studies in animals and humans show that it is often fungicidal and has favorable pharmacokinetics. In conclusion, the management of invasive fungal infections has progressed greatly over the last two decades with the azole antifungals playing a significant role. Related to this class, future research is needed in order to better assess dosing, safety, schedules and areas of use of these agents in infants admitted to the neonatal intensive care unit.

Duke Scholars

Published In

Curr Drug Metab

EISSN

1875-5453

Publication Date

February 2013

Volume

14

Issue

2

Start / End Page

193 / 202

Location

Netherlands

Related Subject Headings

  • Triazoles
  • Pharmacology & Pharmacy
  • Mycoses
  • Infant, Newborn
  • Humans
  • Extracorporeal Membrane Oxygenation
  • Antifungal Agents
  • 3214 Pharmacology and pharmaceutical sciences
  • 1115 Pharmacology and Pharmaceutical Sciences
 

Citation

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Watt, K., Manzoni, P., Cohen-Wolkowiez, M., Rizzollo, S., Boano, E., Jacqz-Aigrain, E., & Benjamin, D. K. (2013). Triazole use in the nursery: fluconazole, voriconazole, posaconazole, and ravuconazole. Curr Drug Metab, 14(2), 193–202.
Watt, Kevin, Paolo Manzoni, Michael Cohen-Wolkowiez, Stefano Rizzollo, Elena Boano, Evelyne Jacqz-Aigrain, and Daniel K. Benjamin. “Triazole use in the nursery: fluconazole, voriconazole, posaconazole, and ravuconazole.Curr Drug Metab 14, no. 2 (February 2013): 193–202.
Watt K, Manzoni P, Cohen-Wolkowiez M, Rizzollo S, Boano E, Jacqz-Aigrain E, et al. Triazole use in the nursery: fluconazole, voriconazole, posaconazole, and ravuconazole. Curr Drug Metab. 2013 Feb;14(2):193–202.
Watt, Kevin, et al. “Triazole use in the nursery: fluconazole, voriconazole, posaconazole, and ravuconazole.Curr Drug Metab, vol. 14, no. 2, Feb. 2013, pp. 193–202.
Watt K, Manzoni P, Cohen-Wolkowiez M, Rizzollo S, Boano E, Jacqz-Aigrain E, Benjamin DK. Triazole use in the nursery: fluconazole, voriconazole, posaconazole, and ravuconazole. Curr Drug Metab. 2013 Feb;14(2):193–202.

Published In

Curr Drug Metab

EISSN

1875-5453

Publication Date

February 2013

Volume

14

Issue

2

Start / End Page

193 / 202

Location

Netherlands

Related Subject Headings

  • Triazoles
  • Pharmacology & Pharmacy
  • Mycoses
  • Infant, Newborn
  • Humans
  • Extracorporeal Membrane Oxygenation
  • Antifungal Agents
  • 3214 Pharmacology and pharmaceutical sciences
  • 1115 Pharmacology and Pharmaceutical Sciences