P043 Amphotericin B in pediatrics: analysis by age stratification suggests a greater chance of adverse events from 13-month of age onward

: Poster session 1, September 21, 2022, 12:30 PM - 1:30 PM BACKGROUND: Deoxycholate amphotericin B (D-AMB) remains an antifungal of great therapeutic value in pediatrics. It is generally accepted that its use in neonates is safer than in older children. However, childhood presents different periods of development which deserves to be evaluated more precisely. Our goal was to assess the usage profile of D-AMB in stratified pediatric age groups, adapted according to the National Institute of Child Health and Human Development (NICHD) classification. METHODS: We conducted a retrospective cross-sectional observational study at a Brazilian tertiary children's hospital. Nonparametric tests were applied, such as the chi-square test to compare proportions and Fisher's exact test to assess the association between categorical variables or in contingency tables. RESULTS: A total of 127 medical records were stratified as preterm neonatal (birth <37 weeks postmenstrual age), term neonatal (birth 27 days), infants (28 days-12 months), toddler (13 months-2 years), early childhood (3-5 years), middle childhood (6-11 years) and early adolescence (12-18 years). Very few acute infusion-related side effects were observed during administration of D-AMB in pediatrics. We found an unfavorable impact of D-AMB from 13 months onward, suggesting this group as a turning point for a greater chance of adverse events, and not soon after the neonatal period as is conventionally known (Fig. 1). CONCLUSIONS: Clinical or observational studies based on age stratification are essential to precisely elucidate whether drugs with toxicity potential can be used safely in the pediatric population. Searching for a turning point has been shown to contribute to the accuracy of the study, while providing more substantial information on the impact of D-AMB on different pediatric age groups.