Antiviral / Antifungal drugs


Anti-rejection drugs make the patient more susceptible to infections. These infections are generally caused by the proliferation of bacteria or viruses normally living in your child’s organism. The following drugs are used to prevent these infections:



Valganciclovir is an antiviral drug that can be used to prevent or treat a virus called cytomegalovirus (CMV). It is possible that your child must take this drug for 3 months after the graft and that additional doses are prescribed for the treatment of a CMV infection. Valganciclovir causes cancer and birth defects in animals, but we do not know if it is the cause of cancer or birth defects in humans. You must thus avoid every direct contact with crushed or broken tablets when administering this drug. Moreover, sexually active men and women must take contraceptive precautions (such as the pill or preservatives) during and at least up to 90 days after the treatment.

The side effects include in particular:

  • neutropenia
  • photosensitivity.

You must thus avoid exposing your child directly to sunlight, by putting sunscreen on his skin or by dressing him to completely cover his skin. Your child’s blood status will be followed up closely as long as he takes this drug. It is also important to encourage him to drink more in order to avoid damage to the kidneys.



Bactrim® is a sulfonamide antibiotic agent. It is used to prevent a type of pneumonia known under the name of pneumonia caused by Pneumocystis jiroveci (PCP). This drug is prescribed during the first year after the graft and its main side effects include:

  • photosensitivity
  • renal failure
  • leucopenia

You must thus avoid exposing your child directly to sunlight, by putting sunscreen on his skin or by dressing him to completely cover his skin. This drug may cause renal calculi and renal failure or reduced white blood count. When this happens, the administration of this drug will be stopped immediately and a replacement drug will be prescribed. It is very important that your child drinks much while taking this drug. When your child is allergic to drugs containing sulfonamides, another drug may be used.

At the same time, your child will take a folic acid supplement in order to protect him from the effects of Bactrim on the white blood cells.



Nystatine is an antifungal drug. It is used to prevent or to treat thrush, a fungal infection of the mouth. Although its salty taste causes nausea in some children, its secondary effects are very rare. Your child might have to take this drug after the graft when he develops a thrush. Nystatine can be dabbed in the mouth of children under two years: on the cheeks, the gums and the tongue. Older children rinse their mouth with the drug and then swallow it. As it is important that a portion of these drugs is swallowed, younger children must be encouraged to suckle at a dabber (small brush similar to a cotton bud). The most effective measure is to leave it in the mouth for some minutes. This drug must be given after the other drugs have been administered and the patient must avoid eating or drinking for 15 minutes.