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. Author manuscript; available in PMC: 2015 Jun 1.
Published in final edited form as: Drugs. 2014 Jun;74(8):891–909. doi: 10.1007/s40265-014-0227-3

Table 2.

Dosing recommendations of antifungal agents in children

Drug Dosing Therapeutic drug
monitoring		 References
Neonates
(0–30 days)		 Infants
(31 days–2 years)		 Children
(2 years–17 years)
Polyenes
  Amphotericin B 0.6−1 mg/kg IV q24h 0.6−1 mg/kg IV q24h 0.6−1 mg/kg IV q24h No [23-27, 167]
  ABLC 2.5−5 mg/kg q24h Unknown 5 mg/kg IV q24h No [39, 50, 51, 183]
  ABCD unknown Unknown Unknown No
  L-AmB 3-5 mg/kg q24h 3–5 mg/kg IV q24h 3–6 mg/kg IV q24h No [47-49, 193]
Triazoles
  Fluconazole Loading dose 25 mg/kg
12 mg/kg q24h
(3–6 mg/kg twice weekly
for prophylaxis)		 12 mg/kg IV q24h
(3 mg/kg IV q24h for
prophylaxis)		 6-12 mg/kg IV or PO q24h
(3 mg/kg q24h for
prophylaxis)		 No [64-66]
  Itraconazole unknown Unknown 2.5–5 mg/kg PO q12h
(2.5 mg/kg PO q24h for
prophylaxis)		 Trough >0.5 mg/Lc [57, 74-76, 78]
  Voriconazole unknown Unknown 7–9 mg/kg IV q12ha
200 mg PO q12h
(2.5 mg/kg PO q12h for
prophylaxis)		 Trough 1.0-5.5 mg/L [62, 91, 99, 190]
  Posaconazole unknown Unknown 200–400 mg PO q6–12 hb Prophylaxis : trough>0.5 mg/Lc
Treatment : trough >1 mg/Lc 		[168]
  Ravuconazole
  Albaconazole
  Isavuconazole 		unknown Unknown unknown unknown
Echinocandins [148-150, 153,
155]
  Caspofungin 25 mg/m2 IV q24h 50 mg/m2 IV q24h Load with 70 mg/m2 IV once,
then 50 mg/m2 IV q24h		 No
  Micafungin 10 mg/kg IV q24h 3–4 mg/kg IV q24h 2–4 mg/kg IV q24h
(1 mg/kg IV q24h for
prophylaxis)		 No [2, 125, 135, 138,
141]
  Anidulafungin Load with 3 mg/kg IV
once,
then 1.5 mg/kg IV q24h		 Load with 3 mg/kg IV
once,
then 1.5 mg/kg IV
q24h		 Load with 3 mg/kg IV once,
then 1.5 mg/kg IV q24h		 No [105, 163, 164]
  Aminocandin unknown unknown unknown unknown
Nucleoside analogs
  5-Flucytosine unknown unknown unknown Cmax : 20−50 mg/Lc [120, 181]

ABCD=amphotericin B colloidal dispersion; ABLC=amphotericin B lipid complex; AUC=area under the concentration-time curve; AUC:MIC=AUC over minimal inhibitory concentration ratio; Cmax= maximal concentration; div=divided dose; EMA=European Medicines Agency; FDA=Food and Drug Administration; IV=intravenous; L-AmB=liposomal amphotericin B; MIC=minimal inhibitory concentration; PD=pharmacodynamics; PO=oral; NR=not reported; q=every; T>MIC=time concentrations are over the MIC.

a

Dosing for <12 years old. For children ≥ 12 years old, adult dosing is recommended.

b

Dosing unknown for children <12 years of age.

c

Target concentrations in adults.