TY - JOUR
T1 - Correct choices for correct treatments
T2 - Key issues in the management of Candida infections in preterm neonates
AU - Manzoni, P.
AU - Stronati, M.
AU - Jacqz-Aigrain, E.
AU - Maragliano, R.
AU - Ruffinazzi, G.
AU - Rizzollo, S.
AU - Castagnola, E.
AU - Farina, D.
PY - 2012/5
Y1 - 2012/5
N2 - Invasive Candida infections (ICI) have a high burden of morbidity and mortality in the neonatal setting. Although the identification of effective prophylactic strategies has recently led to the prevention of many episodes of systemic fungal disease, the identification of effective treatment strategies is still a priority. The correct choice of the most appropriate antifungal drug for treatment of such infections requires specific expertise, as well as careful consideration of a number of variables related both to the characteristics of the patient and to the peculiarities of these infections in neonates. The ideal antifungal drug for preterm neonates should have a good ability to target fungal biofilms, in order to prevent or improve the course of end-organ localisations. It should also be active against fluconazole-resistant species, as well as safe enough to be used with no or limited interference with other neonatal drugs. In this view, the echinocandin class of antifungal agents has recently proven to be a suitable option for treatment. However, further studies are warranted to better establish kinetics and appropriate dosing of these agents in premature and term infants, as well as their ability to improve late outcomes of ICI.
AB - Invasive Candida infections (ICI) have a high burden of morbidity and mortality in the neonatal setting. Although the identification of effective prophylactic strategies has recently led to the prevention of many episodes of systemic fungal disease, the identification of effective treatment strategies is still a priority. The correct choice of the most appropriate antifungal drug for treatment of such infections requires specific expertise, as well as careful consideration of a number of variables related both to the characteristics of the patient and to the peculiarities of these infections in neonates. The ideal antifungal drug for preterm neonates should have a good ability to target fungal biofilms, in order to prevent or improve the course of end-organ localisations. It should also be active against fluconazole-resistant species, as well as safe enough to be used with no or limited interference with other neonatal drugs. In this view, the echinocandin class of antifungal agents has recently proven to be a suitable option for treatment. However, further studies are warranted to better establish kinetics and appropriate dosing of these agents in premature and term infants, as well as their ability to improve late outcomes of ICI.
KW - Antifungal treatment
KW - Biofilms
KW - Candida
KW - Echinocandin
KW - Infection
KW - Neonate
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U2 - 10.1016/S0378-3782(12)70026-9
DO - 10.1016/S0378-3782(12)70026-9
M3 - Article
C2 - 22633526
AN - SCOPUS:84861465929
VL - 88
JO - Early Human Development
JF - Early Human Development
SN - 0378-3782
IS - SUPPL.2
ER -