소아 급성골수성백혈병에서 관해유도 요법 중 Posaconazole의 예방적 항진균 치료
Posaconazole for Prophylaxis of Fungal Infection in Pediatric Patients with Acute Myeloid Leukemia undergoing Induction Chemotherapy
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 broadspectrum 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±16 days. 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.
목차
ABSTRACT 연구 방법 연구 대상 감염의 정의 및 분류 Posaconazole 사용 현황 항진균제 효과 비교 통계분석 연구대상자 보호 연구 결과 대상 환자의 특성 Posaconazole 사용 현황 예방적 항진균제 투여에 따른 효과 비교 Posaconazole 제형에 따른 효과 비교(현탁액군 vs. 장용정군) Posaconazole 현탁액군에서 상호작용 유발 약물 병용에 따른 효과 비교 고찰 결론 참고문헌