Abstract��OBJECTIVE To review systematically the efficacy and safety of echinocandins to invasive candidiasis in pediatric patients. METHODS Databases including multiple databases were searched electronically for randomized controlled trials (RCTs) of echinocandins to invasive candidiasis in pediatric patients up to September 2018. Two reviewers independently screened literatures according to the inclusion and exclusion criteria, extracted data, and assessed the methodological quality of the included studies. Then Meta-analysis was performed using Rev Man 5.3 software. RESULTS A total of 5 RCTs involving 1 190 patients were included. There were 598 patients in the echinocandins group and 592 patients in the control group. Micafungin and caspofungin were retrieved. Fluconazole, and amphotericin B liposome and amphotericin B deoxycholate were used to treat the patient in control group. The results of Meta-analysis showed that there was significant difference between experimental group and control group on the overall effectiveness . Subgroup analysis showed that there were significant difference between caspofungin and control group , also between micafungin and control group . There was significant difference between echinocandins and control group on the subgroup analysis of empiric therapy . There were significant difference between experimental group and control group on the discontinuation due to adverse events . Subgroup analysis showed that there was significant difference between caspofungin and control group . CONCLUSION According to recent analysis, the efficacy and safety of echinocandins in children with invasive candidiasis infections is superior to fluconazole and/or amphotericin B.
�ﳬ, ʷǿ, ������. ����������ҩ�ڶ�ͯ��Ϯ���������Ⱦ��Ӧ�õ���Ч�ԺͰ�ȫ�Ե�ϵͳ���ۺ�Meta����[J]. �й�ҩѧ��־, 2019, 54(8): 659-664.
TIANChao, SHIQiang, WANGXiao-ling. The Efficacy and Safety of Echinocandins to Invasive Candidiasis in Pediatric Patients: A Systematic Review and Meta-Analysis. Chinese Pharmaceutical Journal, 2019, 54(8): 659-664.
ODIO C M, ARAYA R, PINTO L E, et al. Caspofungin therapy of neonates with invasive candidiasis [J]. Pediatr Infect Dis J, 2004, 23 (12):1093-1097.
MPAKOSI A, SIOPI M, FALAINA V, et al. Successful therapy of Candida pulcherrima fungemia in a premature newborn with liposomal amphotericin B and micafungin [J]. Med Mycol Case Rep, 2016, 12: 24-27.
SHI A G. Now antifungal drugs-echinocanding[J]. Chin Pharm J(�й�ҩѧ��־),2006, 41 (2):154-156.
BOTERO-CALDERON L, BENJAMIN D K J R, COHEN-WOLKOWIEZ M. Advances in the treatment of invasive neonatal candidiasis [J]. Expert Opin Pharmacother, 2015, 16 (7):1035-1048.
The Cochrane Collaboration. Cochrane handbook for systematic reviews of interventions version 5.1.0 [EB/OL]. (2011-03) [2017-08-15]. http://handbook. Cochrane.org/.
VAN BURIK J A, RATANATHARATHORN V, STEPAN D E, et al. Micafungin versus fluconazole for prophylaxis against invasive fungal infections during neutropenia in patients undergoing hematopoietic stem cell transplantation [J]. Clin Infect Dis, 2004, 39 (10):1407-1416.
QUEIROZ-TELLES F, BEREZIN E, LEVERGER G, et al. Micafungin versus liposomal amphotericin B for pediatric patients with invasive candidiasis: substudy of a randomized double-blind trial [J]. Pediatr Infect Dis J, 2008, 27 (9):820-826.
MAERTENS J A, MADERO L, REILLY A F, et al. A randomized, double-blind, multicenter study of caspofungin versus liposomal amphotericin B for empiric antifungal therapy in pediatric patients with persistent fever and neutropenia [J]. Pediatr Infect Dis J, 2010, 29 (5):415-420.
MOHAMED W A, ISMAIL M. A randomized, double-blind, prospective study of caspofungin vs. amphotericin B for the treatment of invasive candidiasis in newborn infants [J]. J Trop Pediatr, 2012, 58 (1):25-30.
CASELLI D, CESARO S, ZIINO O, et al. A prospective, randomized study of empirical antifungal therapy for the treatment of chemotherapy-induced febrile neutropenia in children [J]. Br J Haematol, 2012, 158 (2):249-255.
BOTERO-CALDERON L, BENJAMIN D K J R, COHEN-WOLKOWIEZ M. Adverse in the treatment of invasive neonatal candidiasis [J]. Expert Opin Pharmacother, 2015, 16 (7):1035-1048.
LESTNER J M, SMITH P B, COHEN-WOLKOWIEZ M, et al. Antifungal agents and therapy for infants and children with invasive fungal infections: a pharmacological perspective [J]. Br J Clin Pharmacol, 2013, 75(6):1381-1395.
WIEDERHOLD N P, HERRERA L A. Caspofungin for the treatment of immunocompromised and severely ill children and neonates with invasive fungal infections [J]. Clin Med Insights Pediatr, 2012, 7 (6):19-31.
VISCOLI C, BASSETTI M, CASTAGNOLA E, et al. Micafungin for the treatment of proven and suspected invasive candidiasis in children and adults: findings from a multicenter prospective observational study [J]. BMC Infect Dis, 2014,14(1):725.
CAUDLE K E, INGER A G, BUTLER D R, et al. Echinocandin use in the neonatal intensive care unit [J]. Ann Pharmacother, 2012, 46(1):108-116.