Abstract
The increasing use of invasive procedures, antibiotic and immunosuppressive treatments has caused an increase in candidal infections which has led to a search for new antifungal drugs. In our earlier studies (1) ketoconazole (keto), an oral antifungal agent, proved not to be useful in preterms. The absorption of keto was probably prevented due to a combination of low gastric acidity and continuous gavage feeding. We now investigated the bioavailability of itraconazole (itra), also an oral antifungal agent with broad spectrum activity and low toxicity, in preterm infants with a postconceptional age below 32 weeks. Trough and peak serum levels of itra (R51211) and its metabolite (R63373) were measured in 5 preterm infants 48h after initiating therapy with a dose of 5mg/kg of itra in hydroxyprapyl-beta-cyclodextrin solution by HPLC-assay.
We conclude that (2) itra is well absorbed and recommended levels are reached. No side effects of itra were seen. It may be a useful antifungal drug in preterms, but further studies on efficacy and safety are needed.
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van den Anker, J., Koster, M., Heijkants, J. et al. 116 NEW ANTIFUNGAL DRUGS IN TEH PRETERM NEONATE: PHARMACOKINETICS OF KETNAZOLE AND ITRACONAZOLE. Pediatr Res 30, 647 (1991). https://doi.org/10.1203/00006450-199112000-00146
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DOI: https://doi.org/10.1203/00006450-199112000-00146