Introduction
Invasive fungal infections are an important cause of morbidity and
mortality in children. Triazole antifungal agents are increasingly used
for prophylaxis and treatment of mould infections in paediatric oncology
settings, however, confer a risk of azole-induced hepatotoxicity (AIH),
particularly when concomitantly administered with other hepatotoxic
medications. There are limited data on the best approach to AIH. As
triazole antifungal agents are the only antifungal formulation available
in oral form for children, one described approach is switching between
different triazole agents within the azole class to prevent the need for
intravenous (IV) therapy. To date, there have only been three case
reports and one retrospective audit in adults of this approach1-4. This study therefore aimed to describe the
outcomes of switching triazole antifungal agents for AIH in children.