Challenges in the Treatment of Invasive Aspergillosis in Immunocompromised Children

Antimicrob Agents Chemother. 2022 Jul 19;66(7):e0215621. doi: 10.1128/aac.02156-21. Epub 2022 Jun 29.


Invasive aspergillosis (IA) is associated with significant morbidity and mortality. Voriconazole remains the drug of choice for the treatment of IA in children; however, the complex kinetics of voriconazole in children make dosing challenging and therapeutic drug monitoring (TDM) essential for treatment success. The overarching goal of this review is to discuss the role of voriconazole, posaconazole, isavuconazole, liposomal amphotericin B, echinocandins, and combination antifungal therapy for the treatment of IA in children. We also provide a detailed discussion of antifungal TDM in children.

Keywords: invasive aspergillosis; isavuconazole; posaconazole; therapeutic drug monitoring, immunocompromised children; voriconazole.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antifungal Agents / therapeutic use
  • Aspergillosis* / drug therapy
  • Child
  • Echinocandins / therapeutic use
  • Humans
  • Invasive Fungal Infections* / drug therapy
  • Voriconazole / therapeutic use


  • Antifungal Agents
  • Echinocandins
  • Voriconazole