¼Ò¾Æ ±Þ¼º°ñ¼ö¼º¹éÇ÷º´¿¡¼ °üÇØÀ¯µµ ¿ä¹ý Áß PosaconazoleÀÇ ¿¹¹æÀû Ç×Áø±Õ Ä¡·á
Posaconazole for Prophylaxis of Fungal Infection in Pediatric Patients with Acute Myeloid Leukemia undergoing Induction Chemotherapy
Çѱ¹ÀÓ»ó¾àÇÐȸÁö 2018³â 28±Ç 3È£ p.181 ~ p.187
±è½Â¹Î(Kim Seung-Min) - ¿¬¼¼´ëÇб³ÀÇ·á¿ø ¼¼ºê¶õ½ºº´¿ø ¾à¹«±¹
ÀÌÀ±¼±(Ree Yoon-Sun) - ¿¬¼¼´ëÇб³ÀÇ·á¿ø ¼¼ºê¶õ½ºº´¿ø ¾à¹«±¹
±èÀç¼Û(Kim Jae-Song) - ¿¬¼¼´ëÇб³ÀÇ·á¿ø ¼¼ºê¶õ½ºº´¿ø ¾à¹«±¹
±è¼öÇö(Kim Soo-Hyun) - ¿¬¼¼´ëÇб³ÀÇ·á¿ø ¼¼ºê¶õ½ºº´¿ø ¾à¹«±¹
¼ÕÀº¼±(Son Eun-Sun) - ¿¬¼¼´ëÇб³ÀÇ·á¿ø ¼¼ºê¶õ½ºº´¿ø ¾à¹«±¹
À¯Ã¶ÁÖ(Lyu Chuhl-Joo) - ¿¬¼¼´ëÇб³ ¼¼ºê¶õ½ºº´¿ø ¼Ò¾ÆÇ÷¾×Á¾¾ç°ú
Abstract
Background: Posaconazole is a broad-spectrum triazole antifungal agent and the most recommended prophylactic antifungal agent for patients with acute myeloid leukemia (AML) undergoing induction chemotherapy. In this study, we evaluated the status and effectiveness of posaconazole as a prophylactic antifungal agent in pediatric patients receiving induction chemotherapy for AML.
Methods: We retrospectively reviewed the electronic medical records of 36 pediatric patients with AML (between January 2013 and September 2017) at the Yonsei University Health System. Invasive fungal disease (IFD) was assessed as the primary endpoint of prophylactic antifungal effect. The secondary endpoints were incidence of fever, persistent fever despite the use of broad-spectrum antibiotics for 72 h, alteration of antifungal agent, intensive care unit admission, and death within 100 days.
Results: Among the 36 patients, 18 patients used posaconazole, 12 were treated with suspension formula, and 6 of them were treated with tablets. Eighteen patients did not use antifungal agents prophylactically. The mean number of days of posaconazole administration was 26.8¡¾16 days. IFD occurred in 2/18 (11.1%) patients in the no prophylaxis group and in 1/18 (5.6%) patients in the posaconazole group (p=0.49).
Conclusion: Posaconazole is expected to be useful for the prevention of IFD in pediatric patients with AML undergoing induction chemotherapy. Prospective studies of the effectiveness of posaconazole prophylaxis should be conducted in more pediatric patients in the future.
Å°¿öµå
Posaconazole, antifungal prophylaxis, pediatrics, acute myeloid leukemia
¿ø¹® ¹× ¸µÅ©¾Æ¿ô Á¤º¸
µîÀçÀú³Î Á¤º¸
À¯È¿¼º°á°ú(Recomendation)
Posaconazole is expected to be useful for the prevention of IFD in pediatric patients with AML undergoing induction chemotherapy