Document Detail


Selective fluconazole prophylaxis in high-risk babies to reduce invasive fungal infection.
MedLine Citation:
PMID:  17460023     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To evaluate the impact of selective fluconazole prophylaxis on incidence of invasive fungal infection and emergence of fluconazole resistance in neonatal intensive care.
DESIGN: Retrospective study of very low birthweight (VLBW) babies (<1500 g birth weight) admitted to a neonatal intensive care unit (NICU) in the period 1 year before and after the implementation of an antifungal prophylaxis guideline.
PATIENTS: VLBW babies with an additional risk factor: colonisation of Candida species from surface sites with a central venous catheter; third generation cephalosporin treatment; or total duration of antibiotic treatment >10 days. Fluconazole protocol: Fluconazole 6 mg/kg for 3 weeks. Dose interval is every 72 h during the first 2 weeks of life. Thereafter, dose interval is reduced to every 48 h until 3 weeks old when daily fluconazole is given. Fluconazole is administered orally when enteral feeding achieved.
RESULTS: 121 and 107 VLBW babies were admitted to the NICU in the year before and after the guideline was implemented, respectively. Data were available in 110 and 102 charts. 33/110 and 31/102 babies were eligible for fluconazole prophylaxis in the period before and after guideline implementation. 6/33 babies eligible for prophylaxis developed culture proven Candida sepsis before compared with no (0/31) babies after the guideline was implemented (p = 0.03). One baby (1/31) did develop probable Candida sepsis in the post guideline implementation period. During both study periods all Candida isolates remained fully susceptible to fluconazole.
CONCLUSIONS: Selective antifungal prophylaxis has reduced invasive fungal sepsis in one NICU without evidence of fluconazole resistance emerging.
Authors:
Brian A McCrossan; Elaine McHenry; Fiona O'Neill; Grace Ong; David G Sweet
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Publication Detail:
Type:  Journal Article     Date:  2007-04-25
Journal Detail:
Title:  Archives of disease in childhood. Fetal and neonatal edition     Volume:  92     ISSN:  1468-2052     ISO Abbreviation:  Arch. Dis. Child. Fetal Neonatal Ed.     Publication Date:  2007 Nov 
Date Detail:
Created Date:  2007-10-22     Completed Date:  2007-12-11     Revised Date:  2013-06-06    
Medline Journal Info:
Nlm Unique ID:  9501297     Medline TA:  Arch Dis Child Fetal Neonatal Ed     Country:  England    
Other Details:
Languages:  eng     Pagination:  F454-8     Citation Subset:  AIM; IM    
Affiliation:
Regional Neonatal Intensive Care Unit, Royal Maternity Hospital, Grosvenor Road, Belfast BT12 6BJ, Northern Ireland, UK. brianmccrossan@doctors.org.uk
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MeSH Terms
Descriptor/Qualifier:
Antifungal Agents / therapeutic use*
Candidiasis / prevention & control
Chemoprevention
Drug Resistance, Fungal
Fluconazole / therapeutic use*
Fungemia / prevention & control*
Humans
Infant, Newborn
Infant, Very Low Birth Weight*
Intensive Care Units, Neonatal
Patient Selection
Retrospective Studies
Survival Analysis
Chemical
Reg. No./Substance:
0/Antifungal Agents; 86386-73-4/Fluconazole
Comments/Corrections

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


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