Strategies in Antifungal Therapy: What is Different in Children?

Thomas Lehrnbecher, Lars Tramsen, Konrad Bochennek, and Andreas H Groll

Invasive fungal infections continue to represent a major cause of morbidity and mortality in immunocompromised children, as well as in the unique patient population of preterm and term neonates. Although children and adults are similarly vulnerable to invasive fungal infections, important differences between these two patient groups have to be considered. These differences include epidemiology and diagnostic approaches, as well as pharmacokinetics and adverse effects of antifungal agents, all of which have an impact on the antifungal strategy (e.g. prophylaxis, empiric, or pre-emptive treatment, or treatment of established invasive fungal infections). This review focuses on the specific pediatric issues that influence the antifungal approach.

Management of Neonatal Candidiasis

Michael Cohen-Wolkowiez, Daniel K Benjamin Jr , and P Brian Smith

Invasive candidiasis (IC) is common and often fatal in extremely premature neonates. In the last decade, the therapeutic armamentarium for IC has markedly expanded; however, the pharmacokinetics, safety and efficacy of most antifungal agents in premature neonates are unknown. In this article, the authors review the major systemic antifungal agents in clinical use.

A Man with Acute Myeloid Leukemia, Fever, and Hip Pain

Marcela Campo, MD, and Dimitrios P Kontoyiannis, MD

Commentary and Analysis on Recent Key Papers

Zeina A Kanafani, MD, and Michael E Klepser, PharmD, FCCP