Document Detail

Antifungal therapy for newborn infants with invasive fungal infection.
MedLine Citation:
PMID:  22696338     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: A variety of antifungal drugs, drug preparations and drug combinations are available to treat newborn infants with suspected or confirmed invasive fungal infection. There is a need to assess their relative merits.
OBJECTIVES: To assess the effect of treatment with different antifungal drugs, drug preparations or drug combinations on mortality and morbidity in newborn infants with suspected or confirmed invasive fungal infection.
SEARCH METHODS: We used the standard search strategy of the Cochrane Neonatal Review Group. This included searches of the Cochrane Central Register of Controlled Trials (The Cochrane Library, 2012, Issue 2), MEDLINE, EMBASE, CINAHL (to March 2012), conference proceedings and previous reviews.
SELECTION CRITERIA: Randomised and quasi-randomised control trials comparing one antifungal agent or combination of agents with another in newborn infants with suspected or confirmed invasive fungal infection.
DATA COLLECTION AND ANALYSIS: We extracted the data using the standard methods of the Cochrane Neonatal Review Group, with separate evaluation of trial quality and data extraction by each author, and synthesis of data using risk ratio and risk difference.
MAIN RESULTS: We identified only one small trial in which 24 newborn infants participated. This trial compared the use of fluconazole versus amphotericin B (plus 5-fluorocytosine if fungal meningitis present). The trial did not detect a statistically significant effect on mortality (risk ratio 0.73; 95% confidence interval 0.26 to 2.05).
AUTHORS' CONCLUSIONS: There are insufficient data to inform practice. Large randomised controlled trials are required to compare antifungal drugs, drug preparations or drug combinations for treating newborn infants with invasive fungal infection.
Linda Clerihew; William McGuire
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Review     Date:  2012-06-13
Journal Detail:
Title:  The Cochrane database of systematic reviews     Volume:  6     ISSN:  1469-493X     ISO Abbreviation:  Cochrane Database Syst Rev     Publication Date:  2012  
Date Detail:
Created Date:  2012-06-14     Completed Date:  2012-08-13     Revised Date:  2013-06-28    
Medline Journal Info:
Nlm Unique ID:  100909747     Medline TA:  Cochrane Database Syst Rev     Country:  England    
Other Details:
Languages:  eng     Pagination:  CD003953     Citation Subset:  IM    
Department of Paediatrics, Tayside Children’s Hospital, Dundee, UK.
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MeSH Terms
Amphotericin B / therapeutic use
Antifungal Agents / therapeutic use*
Fluconazole / therapeutic use
Flucytosine / therapeutic use
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases / drug therapy*
Mycoses / drug therapy*
Randomized Controlled Trials as Topic
Reg. No./Substance:
0/Antifungal Agents; 1397-89-3/Amphotericin B; 2022-85-7/Flucytosine; 86386-73-4/Fluconazole
Update Of:
Cochrane Database Syst Rev. 2004;(1):CD003953   [PMID:  14974045 ]

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