Antifungal agents in non-neonatologic pediatrics

Elio Castagnola



The spectrum of action of antifungal agents helps driving the choice of the treatment, basing on the activity against the fungus of interest. Pharmacokinetics should also be taken into account, considering the time-dependent and the concentration-dependent drugs. Triazoles belong to the first group, while amphotericin B and echinocandins belong to the second one. The effectiveness of time-dependent drugs hangs on the time spent above the Minimal Inhibitory Concentration (MIC), whereas that of concentration-dependent drugs is related to the peak of concentration achieved. The
tissue penetration is another important factor that should be taken into account while prescribing an antifungal agent. Interactions with other drugs, above all with those used to treat underlying pathologies, should also be considered. Fungicidal drugs are generally preferred to fungistatic agents, therefore echinocandins and amphotericin B are more prescribed than azoles. Combination therapies are not recommended.


Fungal infections; Antifungal agents; Pharmacokinetics; MIC; Penetration; Interactions; Fungicidal; Fungistatic

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