Pediatric Invasive Candidiasis
Conditions
Keywords
Candida, Pediatric, Antifungal
Brief summary
The overarching objective is to develop new evidence-based treatment guidelines for invasive fungal diseases in children. To accomplish that, this protocol will focus on two specific aims: 1) Compare the effectiveness of echinocandin versus amphotericin B or triazole antifungal therapy for pediatric invasive candidiasis and for the subset of patients with invasive candidemia; 2) Characterize the incidence rate of inpatient pediatric invasive candidiasis per hospital admissions.
Detailed description
This study is a multicenter, national and international, prospective observational comparative effectiveness study. The primary aim of this study is to compare the effectiveness of echinocandin versus amphotericin B or triazole antifungal therapy for pediatric invasive candidiasis and for invasive candidemia. The primary effectiveness endpoint for study aim 1 is the comparison of global response at 14 days of antifungal therapy between antifungal therapeutic classes. The secondary effectiveness endpoints for study aim 1 are comparative effectiveness of the 1) global response to antifungal therapy after 30 days and 2) all-cause mortality at 30 days. The secondary aim is to characterize the frequency of pediatric candidiasis by describing the incidence of pediatric candidiasis relative to all pediatric admissions. For this aim, the investigators will use descriptive statistics to establish the frequency of hospital admissions involving an invasive candidiasis per total hospital admissions and total hospital days during the study period.
Interventions
DRUGObservational antifungal therapy
Observational study of primary antifungal therapy utilized and outcomes, including: fluconazole, voriconazole, amphotericin B, caspofungin, and micafungin All agents are given as standard of care.
Sponsors
Children's Hospital of Philadelphia
National Institute of Allergy and Infectious Diseases (NIAID)
Duke University
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
120 Days to 18 Years
Healthy volunteers
No
Inclusion criteria
1. Males or females age \> 120 days and \<18 years 2. Documented proven or probable case of invasive candidiasis 3. Parental/guardian permission (informed consent, if required) and if appropriate, child assent (if required).
Exclusion criteria
1\) Any history of prior Candida infection within the previous 35 days (These patients will not be eligible for analysis in aim 1 but will be eligible for inclusion of aim 2)
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Global response to antifungal therapy | 14 days |
Secondary
| Measure | Time frame |
|---|---|
| Global response of antifungal therapy | 30 days |
| All-cause mortality | 30 days |
Other
| Measure | Time frame |
|---|---|
| Incidence of pediatric invasive fungal infections | 4 years |
Countries
Canada, Colombia, Greece, India, Italy, Saudi Arabia, Spain, United States
Outcome results
None listed