Efficacy and safety of itraconazole use in infants

World J Pediatr. 2016 Nov;12(4):399-407. doi: 10.1007/s12519-016-0034-x. Epub 2016 Jun 10.

Abstract

Background: Itraconazole has been used to treat fungal infections, in particular invasive fungal infections in infants or neonates in many countries.

Data sources: Literature search was conducted through Ovid EMBASE, PubMed, ISI Web of Science, CNKI and Google scholarship using the following key words: "pediatric" or "infant" or "neonate" and "fungal infection" in combination with "itraconazole". Based on the literature and our clinical experience, we outline the administration of itraconazole in infants in order to develop evidence-based pharmacotherapy.

Results: Of 45 articles on the use of itraconazole in infancy, 13 are related to superficial fungal infections including tinea capitis, sporotrichosis, mucosal fungal infections and opportunistic infections. The other 32 articles are related to systemic fungal infections including candidiasis, aspergillosis, histoplasmosis, zygomycosis, trichosporonosis and opportunistic infections as caused by Myceliophthora thermophila.

Conclusion: Itraconazole is safe and effective at a dose of 5 mg/kg per day in a short duration of therapy for superficial fungal infections and 10 mg/kg per day for systemic fungal infections in infants. With a good compliance, it is cost-effective in treating infantile fungal infections. The profiles of adverse events induced by itraconazole in infants are similar to those in adults and children.

Keywords: infant; itraconazole; prophylaxis; superficial fungal infections; systemic fungal infections.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Age Factors
  • Antifungal Agents / therapeutic use*
  • Child
  • Child, Preschool
  • China
  • Dose-Response Relationship, Drug
  • Drug Administration Schedule
  • Evidence-Based Medicine
  • Female
  • Fungemia / drug therapy*
  • Fungemia / microbiology*
  • Fungemia / physiopathology
  • Humans
  • Infant
  • Itraconazole / therapeutic use*
  • Male
  • Mycoses / drug therapy*
  • Mycoses / microbiology*
  • Mycoses / physiopathology
  • Patient Safety / statistics & numerical data
  • Severity of Illness Index
  • Sex Factors
  • Treatment Outcome

Substances

  • Antifungal Agents
  • Itraconazole