Pyrimidines
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Published:2021
2021. "Pyrimidines", Red Book: 2021–2024 Report of the Committee on Infectious Diseases, Committee on Infectious Diseases, American Academy of Pediatrics, David W. Kimberlin, MD, FAAP, Elizabeth D. Barnett, MD, FAAP, Ruth Lynfield, MD, FAAP, Mark H. Sawyer, MD, FAAP
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Among pyrimidine antifungal agents, only flucytosine (5-fluorocytosine) is approved by the US Food and Drug Administration (FDA) for use in children. Flucytosine has a limited spectrum of activity against fungi (Cryptococcus and Candida species) and has potential for toxicity and should be avoided in the setting of renal dysfunction. When flucytosine is used as a single agent, resistance often emerges rapidly. Flucytosine should be used in combination with amphotericin B for cryptococcal meningitis. It is important to monitor serum concentrations of flucytosine to avoid bone marrow toxicity. Flucytosine is only available in oral formulation in the United States.