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Twice-weekly fluconazole prophylaxis in premature infants: Association with cholestasis.
MedLine Citation:
PMID:  21040197     Owner:  NLM     Status:  In-Data-Review    
Background:  Fluconazole prophylaxis is effective in preventing invasive candidiasis in extremely low-birthweight (ELBW) infants. The authors previously reported an increased incidence of cholestasis with fluconazole prophylaxis in ELBW infants, which led to fluconazole prophylaxis being changed to a less frequent dosing (LFD) schedule of twice a week at their institution. The purpose of the present study was therefore to evaluate the effectiveness and safety of LFD fluconazole prophylaxis in preventing invasive candidiasis in ELBW infants. Methods:  ELBW infants who received the LFD regimen of fluconazole (twice a week for up to 6 weeks) were compared with infants who received the frequent dosing (FD) schedule (every 72 h for first 2 weeks, every 48 h for next 2 weeks and every 24 h for the final 2 weeks). The two groups were compared for baseline demographics, risk factors for candidiasis, the rate of invasive fungal infection and the incidence and severity of cholestasis. Results:  There was no significant difference in the incidence of invasive candidiasis in infants who received the LFD (2/104, 2%) compared to FD (0/140, 0%; P= 0.4) fluconazole prophylaxis. The severity of cholestasis was lower and a trend towards decreased incidence of cholestasis was observed on the LFD schedule. Conclusion:  The LFD regimen of fluconazole prophylaxis is effective in preventing invasive fungal infection in ELBW infants. The severity of cholestasis was decreased with the LFD schedule.
Vishwanath Bhat; Milliecor Fojas; Judy G Saslow; Sahil Shah; Sulaiman Sannoh; Barbara Amendolia; Kee Pyon; Nicole Kemble; Gary Stahl; Zubair H Aghai
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pediatrics international : official journal of the Japan Pediatric Society     Volume:  53     ISSN:  1442-200X     ISO Abbreviation:  Pediatr Int     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-08-19     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100886002     Medline TA:  Pediatr Int     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  475-9     Citation Subset:  IM    
Copyright Information:
© 2011 The Authors. Pediatrics International © 2011 Japan Pediatric Society.
Pediatrics/Neonatology, Cooper University Hospital-Robert Wood Johnson Medical School, Camden, New Jersey, USA.
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