Investigation of children undergoing hematoid stem cell transplantation treatedwith amphotericin B administration

Fungal infections in children are among the infections that may affect children as well as adults. The occurrence ofany problem in children will be a difficult and complicated situation because children are unable to express theirproblem and you may not notice their problem for a while. Fungal infections are seen in many babies and children.These fungi generally occur in the folded areas of the skin. Fungi are more visible in the armpit, neck, mouth anddiaper area of the baby. If diagnosed on time, fungal infections in babies can be easily cured, and if neglected, itmay cause more serious complications. Disseminated fungal infection causes significant morbidity and mortality inchildren undergoing hematopoietic stem cell transplantation (HSCT). The widespread use of prophylactic oraltriazoles has limitations of poor absorption, interindividual variability in metabolism, and hepatic toxicity.AmBisome (amphotericin B liposomal complex) has a better safety profile than the parent drug amphotericin B andproduces higher plasma and tissue concentrations. We hypothesized that once-weekly high-dose AmBisome therapycould provide adequate fungal prophylaxis for immunocompromised children undergoing HSCT. We performed apharmacokinetic pilot study to determine whether once-weekly high-dose AmBisome administration would result ineffective concentrations throughout the dosing interval. A total of ۱۴ children (median age, ۳ years, ۱ month; range,۴.۵ months–۹ years, ۹ months) undergoing HSCT received once-weekly intravenous mBisome prophylaxis (۱۰mg/kg as a ۲-hour infusion). Blood samples for pharmacokinetic measurements were drawn around the first and thefourth weekly doses. The concentration of non–lipid-complexed amphotericin in plasma was determined by avalidated bioassay. Recipients of hematopoietic stem cell transplantation (HSCT) are at substantial risk of bacterial,fungal, viral, and parasitic infections depending on the time elapsed since transplantation, presence of graft-versushostdisease (GVHD), and the degree of immunosuppression. Infectious complications in HSCT recipients areassociated with high morbidity and mortality. Bacterial infections constitute the major cause of infectiouscomplications, especially in the early post-transplant period

Keywords:

Pharmacokinetics , infection , fungal infection , amphotericin