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Current Fungal Infection Reports

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01-09-2020 | Amphotericin B | Pediatric Fungal Infections (D Corzo Leon, Section Editor)

Pharmacokinetics and Pharmacodynamics of Antifungal Agents in Neonates and Children

Authors: Charalampos Antachopoulos, Emmanuel Roilides

Published in: Current Fungal Infection Reports | Issue 3/2020

Abstract

Purpose of Review

This review summarizes current knowledge on pharmacokinetics (PK) and pharmacodynamics (PD) of various formulations of amphotericin B, triazoles (fluconazole, itraconazole, voriconazole, posaconazole, isavuconazole), and echinocandins (caspofungin, micafungin, anidulafungin) in the pediatric population.

Recent Findings

The PD indices associated with in vivo outcome have been defined for all antifungal agents. PK parameters have been studied across all range of ages; however, data often originate from small patient series, particularly regarding neonates and young infants. Dose-exposure simulations in population PK studies provide the probability of PD target attainment using various dosage regimens. Therapeutic drug monitoring (TDM) has been recognized as a valuable tool to individualize dosing for azoles due to significant inter-patient variability.

Summary

Our understanding of PK/PD of antifungal agents in pediatric patients has significantly advanced over the last years allowing age-specific dosing recommendations. Yet, however, several PK questions regarding specific patient groups remain to be addressed.

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Title: Pharmacokinetics and Pharmacodynamics of Antifungal Agents in Neonates and Children
Authors: Charalampos Antachopoulos
Emmanuel Roilides
Publication date: 01-09-2020
Publisher: Springer US
Keywords: Amphotericin B
Itraconazole
Candidiasis
Micafungin
Candidiasis
Fluconazole
Pharmacodynamics
Pharmacokinetics
Voriconazole
Caspofungin
Published in: Current Fungal Infection Reports / Issue 3/2020
Print ISSN: 1936-3761
Electronic ISSN: 1936-377X
DOI: https://doi.org/10.1007/s12281-020-00402-6

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