Discrepancies Exist Between Published and Hospital-Based Antifungal Prescription Guidelines for Pediatric Acute Leukemia Patients Infected with Candida spp. and Aspergillus spp.

Ingrid Jacobson

MPH, Epiedmiology

Natalie Vestin

Pediatrics, fungal disease


Pediatric acute leukemia patients are at a high risk of developing invasive fungal infections, the most common of which are caused by Candida spp. and Aspergillus spp. These infections are a significant cause of morbidity and mortality among pediatric patients. Treatments for these infections involve antifungal drugs prescribed for long periods of time. They are known to cause numerous acute and long-term side effects; therefore, antifungal treatment must be optimized for the sake of the patient. The most recently published antifungal guidelines for pediatric acute leukemia patients recommend treating Candida infections with echinocandins and treating Aspergillus infections with voriconazole, with liposomal amphotericin B as an acceptable alternative treatment for both types of infections. USA hospital-based guidelines agree with the most recent published guidelines, however, international hospital-based guidelines do not. These international discrepancies highlight the need for further research into optimizing therapies for fungal infections in pediatric acute leukemia patients.

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