Adverse Events After the Use of Benznidazole in Infants and Children With Chagas Disease

作者：Altcheh Jaime^*; Moscatelli Guillermo; Moroni Samanta; Garcia Bournissen Facundo; Freilij Hector

来源：Pediatrics, 2011, 127(1): E212-E218.

DOI：10.1542/peds.2010-1172

• infant
• children
• Chagas disease
• congenital
• benznidazole
• adverse events
• pediatric pharmacology

BACKGROUND: Chagas disease is caused by infection with Trypanosoma cruzi. In adults, treatment with benznidazole is associated with a high incidence of adverse drug reactions (ADRs). However, in infants and children, treatment with benznidazole seems associated with a lower incidence and decreased severity of ADRs, but these effects have not been clearly characterized.
OBJECTIVE: We aimed to describe ADRs observed in infants and children treated with benznidazole.
PATIENTS AND METHODS: We conducted a prospective cohort study of infants and children in Argentina with Chagas disease treated with benznidazole.
RESULTS: A total of 107 infants and children diagnosed with asymptomatic Chagas disease (mean age: 6.9 years) were enrolled in the study. Sixty-two events (in 44 children) were considered benznidazole related. Mean ADR duration was 8.2 days. ADRs were mild (80.6%), moderate (16%), or severe (3.2%). Most (77.3%) ADRs were in children older than 7 years. Skin was the organ with the highest incidence of ADRs (21%), followed by the central nervous system (9%) and the gastrointestinal tract (8.5%). Also, the ADR rate was lower in infants and toddlers compared with older children (18% vs 53%) (P<.001).
CONCLUSIONS: Treatment with benznidazole was well tolerated in children. Most ADRs were mild and did not require treatment suspension. A strong association was observed between ADR incidence and patient age, and most ADRs occurred in children older than 7 years. We believe that anxiety over potential severe ADRs in children with Chagas disease is not justified and should not be an obstacle to using benznidazole. Pediatrics 2011;127:e212-e218

• 出版日期2011-1