소아 급성골수성백혈병에서 관해유도 요법 중 Posaconazole의 예방적 항진균 치료

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 a...

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Published in한국임상약학회지 Vol. 28; no. 3; pp. 181 - 187
Main Authors 김승민, 이윤선, 김재송, 김수현, 손은선, 유철주, Kim, Seung Min, Ree, Yoon Sun, Kim, Jae Song, Kim, Soo Hyun, Son, Eun Sun, Lyu, Chuhl Joo
Format Journal Article
LanguageKorean
Published 한국임상약학회 30.09.2018
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Summary: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 $26.8{\pm}16days$. 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.
Bibliography:KISTI1.1003/JNL.JAKO201831349947125
ISSN:1226-6051
2508-786X
DOI:10.24304/kjcp.2018.28.3.181