Review of the guidelines for the treatment and prevention of invasive candidiasis in newborns and children

Abstract

nvasive infections caused by Candida species are the most common invasive fungal infections in children of different age groups. Premature neonates, especially newborns with low and extremely low birth-weight, have very high mortality rates, with the highest numbers in case of the central nervous system impairment. Among older children, by analogy with adults, the key risk groups for the development of invasive candidiasis are severely ill patients in intensive care units, as well as children with hematologic malignancies with immunosuppression. The choice of drugs for the treatment of invasive candidiasis in children, especially in infants, requires a very balanced approach, due to the physiological characteristics of the child’s organism, the peculiarities of the flow of infectious process, differences in the pharmacokinetics parametes of drugs, as well as the registered indications for the use of a drug in a specific country including age restrictions. This review will summarize approaches to the treatment and prevention of invasive fungal infections caused Candida spp. in newborns and children, based on existing guidelines. Intentionally in the article are not covered issues of diagnosis of invasive candidiasis, as well as the peculiarities of the clinical pharmacology of antifungal drugs in children, but can be found in several copmprehensive literature reviews.