The Efficacy and Safety of Echinocandins to Invasive Candidiasis in Pediatric Patients: A Systematic Review and Meta-Analysis / 中国药学杂志

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.