Science, M., Robinson, P.D., MacDonald, T., Rassekh, S.R., Dupuis, L.L., & Sung, L. (2014). Guideline for primary antifungal prophylaxis for pediatric patients with cancer or hematopoietic stem cell transplant recipients. Pediatric Blood and Cancer, 61, 393–400.
PURPOSE: To provide healthcare providers with evidence-based recommendations on the use of primary antifungal prophylaxis in children with cancer and undergoing hematopoietic stem cell transplantation (HSCT)
TYPES OF PATIENTS ADDRESSED: Allogeneic and autologous HSCT recipients, children with acute myelogenous leukemia (AML) or myelodysplastic syndrome (MDS), and pediatric patients with anticipated neutropenia for longer than seven days
RESOURCE TYPE: Evidence-based guideline
PROCESS OF DEVELOPMENT: Literature search was done, and included studies were evaluated using the Grades of Recommendation, Assessment, Development, and Evaluation system. Recommendations were established by a panel discussion. Guidelines then were externally reviewed by another interprofessional expert panel and provided to Canadian pediatric tertiary hospitals for stakeholder review.
DATABASES USED: MEDLINE, EMBASE, Cochrane Collaboration, proceedings of the American Society of Clinical Oncology and American Society of Hematology
KEYWORDS: Not stated
INCLUSION CRITERIA: RCTs involving patients of any age with cancer or undergoing HSCT that compared antifungal agents with another antifungal agent, placebo, or no prophylaxis; no language exclusions
EXCLUSION CRITERIA: Trials involving nonsystemic antifungal treatment
Initially, 7,869 references were retrieved and screened. A final set of 47 studies were included.
The following are strong recommendations.
Additional weak recommendations also are outlined in the guidelines.
Although these guidelines are aimed at pediatric patients, 17 studies included did not include children in the sample.
These evidence-based guidelines clearly recommend primary antifungal prophylaxis in at-risk children. Specific dosages recommended are identified in this reference.