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Novel Insights into Fungal Infections Prophylaxis and Treatment in Pediatric Patients with Cancer

Invasive fungal diseases (IFDs) are a relevant cause of morbidity and mortality in children with cancer. Their correct prevention and management impact patients’ outcomes. The aim of this review is to highlight the rationale and novel insights into antifungal prophylaxis and treatment in pediatric p...

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Autores principales: Bossù, Gianluca, Di Sario, Riccardo, Muratore, Edoardo, Leardini, Davide, Pession, Andrea, Esposito, Susanna, Masetti, Riccardo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9598217/
https://www.ncbi.nlm.nih.gov/pubmed/36289974
http://dx.doi.org/10.3390/antibiotics11101316
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author Bossù, Gianluca
Di Sario, Riccardo
Muratore, Edoardo
Leardini, Davide
Pession, Andrea
Esposito, Susanna
Masetti, Riccardo
author_facet Bossù, Gianluca
Di Sario, Riccardo
Muratore, Edoardo
Leardini, Davide
Pession, Andrea
Esposito, Susanna
Masetti, Riccardo
author_sort Bossù, Gianluca
collection PubMed
description Invasive fungal diseases (IFDs) are a relevant cause of morbidity and mortality in children with cancer. Their correct prevention and management impact patients’ outcomes. The aim of this review is to highlight the rationale and novel insights into antifungal prophylaxis and treatment in pediatric patients with oncological and hematological diseases. The literature analysis showed that IFDs represent a minority of cases in comparison to bacterial and viral infections, but their impact might be far more serious, especially when prolonged antifungal therapy or invasive surgical treatments are required to eradicate colonization. A personalized approach is recommended since pediatric patients with cancer often present with different complications and require tailored therapy. Moreover, while the Aspergillus infection rate does not seem to increase, in the near future, new therapeutic recommendations should be required in light of new epidemiological data on Candidemia due to resistant species. Finally, further studies on CAR-T treatment and other immunotherapies are needed in patients with unique needs and the risk of complications. Definitive guidelines on IFD treatment considering the evolving epidemiology of antifungal resistance, new therapeutic approaches in pediatric cancer, novel antifungal drugs and the importance of an appropriate antifungal stewardship are urgently needed.
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spelling pubmed-95982172022-10-27 Novel Insights into Fungal Infections Prophylaxis and Treatment in Pediatric Patients with Cancer Bossù, Gianluca Di Sario, Riccardo Muratore, Edoardo Leardini, Davide Pession, Andrea Esposito, Susanna Masetti, Riccardo Antibiotics (Basel) Review Invasive fungal diseases (IFDs) are a relevant cause of morbidity and mortality in children with cancer. Their correct prevention and management impact patients’ outcomes. The aim of this review is to highlight the rationale and novel insights into antifungal prophylaxis and treatment in pediatric patients with oncological and hematological diseases. The literature analysis showed that IFDs represent a minority of cases in comparison to bacterial and viral infections, but their impact might be far more serious, especially when prolonged antifungal therapy or invasive surgical treatments are required to eradicate colonization. A personalized approach is recommended since pediatric patients with cancer often present with different complications and require tailored therapy. Moreover, while the Aspergillus infection rate does not seem to increase, in the near future, new therapeutic recommendations should be required in light of new epidemiological data on Candidemia due to resistant species. Finally, further studies on CAR-T treatment and other immunotherapies are needed in patients with unique needs and the risk of complications. Definitive guidelines on IFD treatment considering the evolving epidemiology of antifungal resistance, new therapeutic approaches in pediatric cancer, novel antifungal drugs and the importance of an appropriate antifungal stewardship are urgently needed. MDPI 2022-09-27 /pmc/articles/PMC9598217/ /pubmed/36289974 http://dx.doi.org/10.3390/antibiotics11101316 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Bossù, Gianluca
Di Sario, Riccardo
Muratore, Edoardo
Leardini, Davide
Pession, Andrea
Esposito, Susanna
Masetti, Riccardo
Novel Insights into Fungal Infections Prophylaxis and Treatment in Pediatric Patients with Cancer
title Novel Insights into Fungal Infections Prophylaxis and Treatment in Pediatric Patients with Cancer
title_full Novel Insights into Fungal Infections Prophylaxis and Treatment in Pediatric Patients with Cancer
title_fullStr Novel Insights into Fungal Infections Prophylaxis and Treatment in Pediatric Patients with Cancer
title_full_unstemmed Novel Insights into Fungal Infections Prophylaxis and Treatment in Pediatric Patients with Cancer
title_short Novel Insights into Fungal Infections Prophylaxis and Treatment in Pediatric Patients with Cancer
title_sort novel insights into fungal infections prophylaxis and treatment in pediatric patients with cancer
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9598217/
https://www.ncbi.nlm.nih.gov/pubmed/36289974
http://dx.doi.org/10.3390/antibiotics11101316
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