دورية أكاديمية
An evidence-based, risk-adapted algorithm for antifungal prophylaxis reduces risk for invasive mold infections in children with hematologic malignancies.
العنوان: | An evidence-based, risk-adapted algorithm for antifungal prophylaxis reduces risk for invasive mold infections in children with hematologic malignancies. |
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المؤلفون: | Dutta A; Department of Pediatrics, Section of Infectious Diseases, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA., Ikwuezunma A; University of Texas Medical School, Rio Grande Valley, Edinburg, Texas, USA., Castellanos MI; Department of Pediatrics, Section of Hematology and Oncology, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA., Brackett J; Department of Pediatrics, Section of Hematology and Oncology, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA., Reddy K; Department of Pediatrics, Section of Hematology and Oncology, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA., Mahajan P; Department of Pediatrics, Section of Hematology and Oncology, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA., Marshburn AM; Department of Pediatrics, Division of Pediatric Hospital Medicine, UTHealth Science Center, Houston, Texas, USA., Kamdar K; Department of Pediatrics, Section of Hematology and Oncology, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA., Paek H; Department of Pharmacy, Texas Children's Hospital, Houston, Texas, USA., Palazzi DL; Department of Pediatrics, Section of Infectious Diseases, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA., Rabin KR; Department of Pediatrics, Section of Hematology and Oncology, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA., Scheurer ME; Department of Pediatrics, Section of Hematology and Oncology, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA., Gramatges MM; Department of Pediatrics, Section of Hematology and Oncology, Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA. |
المصدر: | Pediatric blood & cancer [Pediatr Blood Cancer] 2021 Dec; Vol. 68 (12), pp. e29228. Date of Electronic Publication: 2021 Jul 16. |
نوع المنشور: | Journal Article; Research Support, Non-U.S. Gov't |
اللغة: | English |
بيانات الدورية: | Publisher: John Wiley Country of Publication: United States NLM ID: 101186624 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1545-5017 (Electronic) Linking ISSN: 15455009 NLM ISO Abbreviation: Pediatr Blood Cancer Subsets: MEDLINE |
أسماء مطبوعة: | Original Publication: Hoboken, N.J. : John Wiley, c 2004- |
مواضيع طبية MeSH: | Hematologic Neoplasms*/complications , Hematologic Neoplasms*/drug therapy , Mycoses*/etiology , Mycoses*/prevention & control, Algorithms ; Antifungal Agents/therapeutic use ; Child ; Humans ; Retrospective Studies |
مستخلص: | Background: Children with hematologic malignancies, especially those who receive intensive chemotherapy, are at high risk for invasive mold infections (IMI) that confer substantial mortality. Randomized controlled trials support the use of antifungal prophylaxis with antimold activity as an optimal strategy for risk reduction in this population, but studies outlining the practical application of evidence-based recommendations are lacking. Procedure: We conducted a 15-year, single-institution retrospective review in a diverse cohort of children with hematologic malignancies treated with chemotherapy to determine the incidence of proven or probable IMI diagnosed between 2006 and 2020. Multivariable logistic regression was used to identify host and disease factors associated with IMI risk. We then compared the incidence and type of IMI and related factors before and after 2016 implementation of an evidence-based, risk-adapted antifungal prophylaxis algorithm that broadened coverage to include molds in patients at highest risk for IMI. Results: We identified 61 cases of proven or probable IMI in 1456 patients diagnosed with hematologic malignancies during the study period (4.2%). Implementation of an antifungal prophylaxis algorithm reduced the IMI incidence in this population from 4.8% to 2.9%. Both Hispanic ethnicity and cancer diagnosis prior to 2016 were associated with risk for IMI. Conclusion: An evidence-based, risk-adapted approach to antifungal prophylaxis for children with hematologic malignancies is an effective strategy to reduce incidence of IMI. (© 2021 Wiley Periodicals LLC.) |
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فهرسة مساهمة: | Keywords: antifungal prophylaxis; invasive mold infection; leukemia; lymphoma |
المشرفين على المادة: | 0 (Antifungal Agents) |
تواريخ الأحداث: | Date Created: 20210716 Date Completed: 20220415 Latest Revision: 20220415 |
رمز التحديث: | 20231215 |
DOI: | 10.1002/pbc.29228 |
PMID: | 34268879 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1545-5017 |
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DOI: | 10.1002/pbc.29228 |