Document Detail


Prophylactic oral nystatin for preterm babies under 33 weeks' gestation decreases fungal colonisation and invasive fungaemia.
MedLine Citation:
PMID:  19036756     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Invasive fungal infection is an important cause of mortality and morbidity in extremely preterm babies. Colonisation with Candida is a risk factor for systemic infection. A policy of oral nystatin prophylaxis was introduced in November 2000 with the aim of reducing the incidence of invasive fungaemia. AIM: To determine whether this policy had reduced the rates of fungal colonisation and invasive fungal infection. METHODS: All neonates of <33 weeks' gestation born between 1998 and 2003 were studied. Neonates born between January 1998 and October 2000 who did not receive nystatin prophylaxis (group A) were compared with those born between November 2000 and December 2003 who received nystatin prophylaxis (group B). Infant details, blood culture results and the results of weekly surface swabs were recorded. RESULTS: 1459 neonates (group A = 724 , group B = 735) of <33 weeks' gestation were admitted in the study period. There were no differences in birth weight, gestation, gender or proportion of babies transferred in from other units between the groups. There was a reduction in colonisation from 257 (35.5%) in group A to 132 (18%) in group B. The incidence of invasive fungaemia decreased from 30 (4.1%) to 13 (1.8%) between the two groups. There was also a reduction in mortality between the two groups from 17.8% to 11.8%. CONCLUSIONS: The introduction of a prophylactic nystatin administration policy for babies born before 33 weeks was associated with a significant reduction in fungal colonisation and invasive fungal infection.
Authors:
K Ganesan; S Harigopal; T Neal; C W Yoxall
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Publication Detail:
Type:  Journal Article     Date:  2008-11-26
Journal Detail:
Title:  Archives of disease in childhood. Fetal and neonatal edition     Volume:  94     ISSN:  1468-2052     ISO Abbreviation:  Arch. Dis. Child. Fetal Neonatal Ed.     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-06-22     Completed Date:  2009-08-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9501297     Medline TA:  Arch Dis Child Fetal Neonatal Ed     Country:  England    
Other Details:
Languages:  eng     Pagination:  F275-8     Citation Subset:  AIM; IM    
Affiliation:
Liverpool Women's Hospital NHS Foundation Trust, Liverpool L8 7SS, UK.
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MeSH Terms
Descriptor/Qualifier:
Antifungal Agents / therapeutic use*
Candida / classification,  isolation & purification
Candidiasis / prevention & control
Drug Evaluation
Female
Fungemia / prevention & control*
Humans
Infant Care / methods
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases / prevention & control*
Infant, Very Low Birth Weight
Male
Nystatin / therapeutic use*
Retrospective Studies
Chemical
Reg. No./Substance:
0/Antifungal Agents; 1400-61-9/Nystatin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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