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Oral itraconazole in treatment of candidemia in a pediatric intensive care unit

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Abstract

Objective: To examine efficacy of itraconazole in the treatment of candidemia in critically ill children.Methods: We studied retrospectively cases of candidemia seen consecutively in our Pediatric Intensive Care Unit (PICU) over three and half year.Candida isolates from those patients included.Candida albicans- 19, C.tropicalis-31,C. guillermondii- 9,C.krusei- 4 andC. glabrata-1Results: Of the 64 patients, 48 (75%) had symptoms suggestive of septicemia and 16 had no symptoms suggestive of septicemia. No antifungal therapy was given to asymptomatic patients; they recovered from candidemia without development of any sequelae. Of the 48 symptomatic patients 11 died before results of fungal culture became available and antifungal therapy could be started. Thirty seven patients were treated with itraconazole (10 mg/kg/day orally or through gastric tube). Seven (18.9 %) of 37 patients died, 3 within first week of antifungal therapy. Thirty (81%) patients recovered; microbiological cure was noted on average by day 14 (range 4–30 days). The mean ±SD duration of therapy in patients who responded was 24 ±7 days (range 21–42 days). None had any major side effect.Conclusion: We conclude that oral itraconazole may be effective in treatment of candidemia in children in a PICU where non-C.albicans Candida species constituted majority (70%) of allCandida isolates.

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Authors and Affiliations

  1. Departments of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India

    Sunit C. Singhi, Thimmapuram C. S. Reddy & Arunaloke Chakrabarti

  2. Departments of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India

    Arunaloke Chakrabarti

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  1. Sunit C. Singhi
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  2. Thimmapuram C. S. Reddy
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  3. Arunaloke Chakrabarti
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Correspondence to Sunit C. Singhi.

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Singhi, S.C., Reddy, T.C.S. & Chakrabarti, A. Oral itraconazole in treatment of candidemia in a pediatric intensive care unit. Indian J Pediatr 71, 973–977 (2004). https://doi.org/10.1007/BF02828109

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