Document Detail


Empiric antifungal therapy and outcomes in extremely low birth weight infants with invasive candidiasis.
MedLine Citation:
PMID:  22424952     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To assess the impact of empiric antifungal therapy for invasive candidiasis on subsequent outcomes in premature infants.
STUDY DESIGN: This was a cohort study of infants with a birth weight ≤ 1000 g receiving care at Neonatal Research Network sites. All infants had at least one positive culture for Candida. Empiric antifungal therapy was defined as receipt of a systemic antifungal on the day of or the day before the first positive culture for Candida was drawn. We created Cox proportional hazards and logistic regression models stratified on propensity score quartiles to determine the effect of empiric antifungal therapy on survival, time to clearance of infection, retinopathy of prematurity, bronchopulmonary dysplasia, end-organ damage, and neurodevelopmental impairment (NDI).
RESULTS: A total of 136 infants developed invasive candidiasis. The incidence of death or NDI was lower in infants who received empiric antifungal therapy (19 of 38; 50%) compared with those who had not (55 of 86; 64%; OR, 0.27; 95% CI, 0.08-0.86). There was no significant difference between the groups for any single outcome or other combined outcomes.
CONCLUSION: Empiric antifungal therapy was associated with increased survival without NDI. A prospective randomized trial of this strategy is warranted.
Authors:
Rachel G Greenberg; Daniel K Benjamin; Marie G Gantz; C Michael Cotten; Barbara J Stoll; Michele C Walsh; Pablo J Sánchez; Seetha Shankaran; Abhik Das; Rosemary D Higgins; Nancy A Miller; Kathy J Auten; Thomas J Walsh; Abbot R Laptook; Waldemar A Carlo; Kathleen A Kennedy; Neil N Finer; Shahnaz Duara; Kurt Schibler; Richard A Ehrenkranz; Krisa P Van Meurs; Ivan D Frantz; Dale L Phelps; Brenda B Poindexter; Edward F Bell; T Michael O'Shea; Kristi L Watterberg; Ronald N Goldberg; P Brian Smith;
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural     Date:  2012-03-15
Journal Detail:
Title:  The Journal of pediatrics     Volume:  161     ISSN:  1097-6833     ISO Abbreviation:  J. Pediatr.     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-07-26     Completed Date:  2012-10-02     Revised Date:  2014-09-12    
Medline Journal Info:
Nlm Unique ID:  0375410     Medline TA:  J Pediatr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  264-9.e2     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012 Mosby, Inc. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Antifungal Agents / therapeutic use*
Candidiasis, Invasive / diagnosis,  drug therapy*,  mortality,  prevention & control
Female
Humans
Infant, Extremely Low Birth Weight*
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases / diagnosis,  drug therapy*,  mortality,  prevention & control
Male
Survival Rate
Treatment Outcome
Grant Support
ID/Acronym/Agency:
K23 HD044799/HD/NICHD NIH HHS; K23 HD044799-02/HD/NICHD NIH HHS; K23 HD060040/HD/NICHD NIH HHS; K23 HD060040-04/HD/NICHD NIH HHS; K24 HD058735/HD/NICHD NIH HHS; L40 HD069892/HD/NICHD NIH HHS; L40 HD069892-04/HD/NICHD NIH HHS; R01 HD057956/HD/NICHD NIH HHS; R01 HD057956-05/HD/NICHD NIH HHS; U10 HD053089/HD/NICHD NIH HHS; UL1 TR000041/TR/NCATS NIH HHS; UL1 TR000454/TR/NCATS NIH HHS
Chemical
Reg. No./Substance:
0/Antifungal Agents
Investigator
Investigator/Affiliation:
Daniel K Benjamin / ; Ronald N Goldberg / ; Pablo J Sánchez / ; Seetha Shankaran / ; Barbara J Stoll / ; Michele C Walsh / ; Abhik Das / ; Rosemary D Higgins / ; Nancy A Miller / ; Kathy J Auten / ; Alan H Jobe / ; Michael S Caplan / ; William Oh / ; Betty R Vohr / ; Angelita M Hensman / ; Theresa M Leach / ; Victoria E Watson / ; Lucy Noel / ; Bonnie E Stephens / ; Dawn Andrews / ; Kristen Angela / ; Barbara Alksninis / ; Suzy Ventura / ; Avroy A Fanaroff / ; Deanne E Wilson-Costello / ; Nancy S Newman / ; Harriet G Friedman / ; Bonnie S Siner / ; Edward F Donovan / ; Jean J Steichen / ; Kimberly Yolton / ; Barbara Alexander / ; Kate Bridges / ; Teresa L Gratton / ; Cathy Grisby / ; Jody Hessling / ; Holly L Mincey / ; Ricki F Goldstein / ; Kimberley A Fisher / ; Katherine A Foy / ; Sandra Grimes / ; Kathryn E Gustafson / ; Melody B Lohmeyer / ; Yun F Wang / ; Ellen C Hale / ; Ann Blackwelder / ; David P Carlton / ; Maureen Mulligan LaRossa / ; Sheena Carter / ; Gloria Smikle / ; Lynn Wineski / ; Stephanie Wilson Archer / ; Elisabeth C McGowan / ; Brenda L MacKinnon / ; Ellen Nylen / ; Anne Furey / ; Cecelia Sibley / ; Ana Brussa / ; Anna M Dusick / ; James A Lemons / ; Ann B Cook / ; Faithe Hamer / ; Dianne E Herron / ; Carolyn Lytle / ; Heike M Minnich / ; Leslie Dawn Wilson / ; W Kenneth Poole / ; Jeanette O'Donnell Auman / ; Margaret Cunningham / ; Betty K Hastings / ; Elizabeth M McClure / ; Jamie E Newman / ; Carolyn M Petrie Huitema / ; James W Pickett / ; Scott E Schaefer / ; Kristin M Zaterka-Baxter / ; David K Stevenson / ; Susan R Hintz / ; M Bethany Ball / ; Anne M DeBattista / ; Alexis S Davis / ; Jean G Kohn / ; Hali E Weiss / ; Barbara Bentley / ; Ginger K Brudos / ; Renee P Pyle / ; Myriam Peralta-Carcelen / ; Namasivayam Ambalavanan / ; Monica V Collins / ; Shirley S Cosby / ; Fred J Biasini / ; Kristen C Johnston / ; Kathleen G Nelson / ; Cryshelle S Patterson / ; Vivien A Phillips / ; Richard V Rector / ; Sally Whitley / ; Maynard R Rasmussen / ; David Kaegi / ; Yvonne E Vaucher / ; Kathy Arnell / ; Renee Bridge / ; Clarence Demetrio / ; Martha G Fuller / ; Chris Henderson / ; Wade Rich / ; John A Widness / ; Michael J Acarregui / ; Karen J Johnson / ; Diane L Eastman / ; Charles R Bauer / ; Ruth Everett-Thomas / ; Amy Mur Worth / ; Maria Calejo / ; Alexis N Diaz / ; Silvia M Frade Eguaras / ; Yamiley C Gideon / ; Sylvia Hiriart-Fajardo / ; Ann Londono / ; Elaine O Mathews / ; Alexandra Stroerger / ; Robin K Ohls / ; Janell Fuller / ; Conra Backstrom Lacy / ; Gary J Myers / ; Linda J Reubens / ; Erica Burnell / ; Diane Hust / ; Rosemary L Jensen / ; Julie Babish Johnson / ; Emily Kushner / ; Kelley Yost / ; Lauren Zwetsch / ; Joan Merzbach / ; Charles R Rosenfeld / ; Walid A Salhab / ; Alicia Guzman / ; Gaynelle Hensley / ; Melissa H Leps / ; Roy J Heyne / ; Janet S Morgan / ; Lizette E Torres / ; Catherine Twell Boatman / ; Sally S Adams / ; Elizabeth Heyne / ; Linda A Madden / ; Jon E Tyson / ; Patricia W Evans / ; Margarita Jiminez / ; Brenda H Morris / ; Saba Siddiki / ; Esther G Akpa / ; Nora I Alaniz / ; Susan Dieterich / ; Beverly Foley Harris / ; Charles Green / ; Anna E Lis / ; Sarah Martin / ; Georgia E McDavid / ; Patti L Pierce Tate / ; M Layne Poundstone / ; Stacey Reddoch / ; Maegan C Simmons / ; Sharon L Wright / ; Robert G Dillard / ; Nancy J Peters / ; Korinne Chiu / ; Deborah Evans Allred / ; Donald J Goldstein / ; Carroll Peterson / ; Ellen L Waldrep / ; Lisa K Washburn / ; Barbara G Jackson / ; Athina Pappas / ; Rebecca Bara / ; Laura Goldston / ; Rachel L Chapman / ; Patricia Gettner / ; Monica Konstantino / ; JoAnn Poulsen / ; Elaine Romano / ; Janet Taft / ; Joanne Williams /
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