Is There Still a Place for Conventional Amphotericin B in the Treatment of Neonatal Fungal Infections?

Abstract

Neonatal invasive fungal infections (IFIs) remain an increasing problem associated with high rates of morbidity and mortality, as well as late-onset neurodevelopmental implications. Invasive candidiasis remains the leading neonatal IFI. Candida albicans is the fungal species most often affecting this population, although a changing epidemiologic incidence to non-albicans Candida species is reported in some neonatal intensive care units. Many treatment recommendations are extrapolated from adult populations, emphasizing the need to establish the optimal antifungal agent, dosage, and duration of therapy in neonates. Historically, conventional amphotericin B has been considered an efficient and safe treatment approach for most neonatal IFIs. More recently, lipid formulations of amphotericin B have been studied, used alone or in combination with other antifungal agents such as azoles or echinocandins. The aim of this article is to review the published experience in the use of amphotericin B formulations to treat neonatal IFIs.

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Disclosure

Conflicts of Interest: Z-D. Pana: none; M. Ioannidou: none; E. Roilides: Payment for speaking and development of educational presentations from Gilead, Cephalon, Pfizer, Schering, Merck, and Astellas.

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Pana, ZD., Ioannidou, M. & Roilides, E. Is There Still a Place for Conventional Amphotericin B in the Treatment of Neonatal Fungal Infections?. Curr Fungal Infect Rep 6, 81–94 (2012). https://doi.org/10.1007/s12281-011-0074-6

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Keywords

  • Neonates
  • Infants
  • Fungal infections
  • Amphotericin B
  • Treatment
  • Antifungal agents
  • Candida infection
  • Candidiasis
  • Drug combinations