The Role of Antifungals in Pediatric Critical Care Invasive Fungal Infections

Invasive fungal infections (IFIs) have seen considerable increase in pediatric intensive care units over the past several decades. IFIs are predominantly caused by Candida species, and candidemia is the third most common cause of healthcare-associated bloodstream infections (BSIs) in children. IFIs...

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Main Authors: Ashlesha Kaushik, Helen Kest
Format: Article
Language:English
Published: Wiley 2018-01-01
Series:Critical Care Research and Practice
Online Access:http://dx.doi.org/10.1155/2018/8469585
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author Ashlesha Kaushik
Helen Kest
author_facet Ashlesha Kaushik
Helen Kest
author_sort Ashlesha Kaushik
collection DOAJ
description Invasive fungal infections (IFIs) have seen considerable increase in pediatric intensive care units over the past several decades. IFIs are predominantly caused by Candida species, and candidemia is the third most common cause of healthcare-associated bloodstream infections (BSIs) in children. IFIs are opportunistic infections that affect pediatric patients in critical care resulting in significant morbidity and mortality especially in those with a compromised immune system. IFIs are the leading cause of death in children with comorbidities such as immunosuppression, and pediatric ICU admission has been shown to be an independent risk factor for mortality. Management of IFI and fungal sepsis is broad and encompasses several key components that include prompt initiation of therapy and rapid source identification and control. This study reviews important antifungals in the pediatric critical care setting including the pharmacologic properties, antifungal spectrum, adverse effects, and clinical uses of agents belonging to the four major classes of antifungals—the polyenes, azoles, echinocandins, and pyrimidine analogue flucytosine. The polyenes and azoles are the most often used classes of antifungals. The echinocandins are a relatively newer class of antifungal agents that offer excellent Candida activity and are currently recommended as the first-line therapy for invasive candidiasis.
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spelling doaj-art-4dc20fc17f504fe1b860938ba0bd3ece2025-08-20T03:36:22ZengWileyCritical Care Research and Practice2090-13052090-13132018-01-01201810.1155/2018/84695858469585The Role of Antifungals in Pediatric Critical Care Invasive Fungal InfectionsAshlesha Kaushik0Helen Kest1Pediatric Infectious Diseases, Unity Point Health and Siouxland Medical Education Foundation, Department of Pediatrics, University of Iowa Carver College of Medicine, 2720 Stone Park Blvd, Sioux City, IA 51104, USAPediatric Infectious Diseases, Unity Point Health and Siouxland Medical Education Foundation, Department of Pediatrics, University of Iowa Carver College of Medicine, 2720 Stone Park Blvd, Sioux City, IA 51104, USAInvasive fungal infections (IFIs) have seen considerable increase in pediatric intensive care units over the past several decades. IFIs are predominantly caused by Candida species, and candidemia is the third most common cause of healthcare-associated bloodstream infections (BSIs) in children. IFIs are opportunistic infections that affect pediatric patients in critical care resulting in significant morbidity and mortality especially in those with a compromised immune system. IFIs are the leading cause of death in children with comorbidities such as immunosuppression, and pediatric ICU admission has been shown to be an independent risk factor for mortality. Management of IFI and fungal sepsis is broad and encompasses several key components that include prompt initiation of therapy and rapid source identification and control. This study reviews important antifungals in the pediatric critical care setting including the pharmacologic properties, antifungal spectrum, adverse effects, and clinical uses of agents belonging to the four major classes of antifungals—the polyenes, azoles, echinocandins, and pyrimidine analogue flucytosine. The polyenes and azoles are the most often used classes of antifungals. The echinocandins are a relatively newer class of antifungal agents that offer excellent Candida activity and are currently recommended as the first-line therapy for invasive candidiasis.http://dx.doi.org/10.1155/2018/8469585
spellingShingle Ashlesha Kaushik
Helen Kest
The Role of Antifungals in Pediatric Critical Care Invasive Fungal Infections
Critical Care Research and Practice
title The Role of Antifungals in Pediatric Critical Care Invasive Fungal Infections
title_full The Role of Antifungals in Pediatric Critical Care Invasive Fungal Infections
title_fullStr The Role of Antifungals in Pediatric Critical Care Invasive Fungal Infections
title_full_unstemmed The Role of Antifungals in Pediatric Critical Care Invasive Fungal Infections
title_short The Role of Antifungals in Pediatric Critical Care Invasive Fungal Infections
title_sort role of antifungals in pediatric critical care invasive fungal infections
url http://dx.doi.org/10.1155/2018/8469585
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