Fluconazole Prophylaxis against Fungal Colonization and Infection in Preterm Infants

Invasive fungal infections cause substantial morbidity and mortality in preterm infants. In this single-center, double-blind, placebo-controlled trial, extremely-low-birth-weight preterm infants who were given the antifungal agent fluconazole prophylactically for six weeks had significantly lower ra...

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Bibliographic Details
Published in:	The New England journal of medicine Vol. 345; no. 23; pp. 1660 - 1666
Main Authors:	Kaufman, David, Boyle, Robert, Hazen, Kevin C, Patrie, James T, Robinson, Melinda, Donowitz, Leigh Goodman
Format:	Journal Article
Language:	English
Published:	Boston, MA Massachusetts Medical Society 06-12-2001
Subjects:	Antibiotics. Antiinfectious agents. Antiparasitic agents Antifungal agents Antifungal Agents - adverse effects Antifungal Agents - therapeutic use Babies Bacterial infections Bacterial Infections - epidemiology Biological and medical sciences Birth weight Candida - drug effects Candida - isolation & purification Candida albicans - drug effects Candida albicans - isolation & purification Candidiasis - prevention & control Colony Count, Microbial Double-Blind Method Fluconazole - adverse effects Fluconazole - therapeutic use Fungal infections Humans Infant, Newborn Infant, Premature Infant, Premature, Diseases - prevention & control Infant, Very Low Birth Weight Infusions, Intravenous Intensive care Medical sciences Microbial Sensitivity Tests Mortality Mycoses - prevention & control Pharmacology. Drug treatments Prospective Studies Trichosporon - isolation & purification Human Infection Premature Prevention Antifungal agent Chemotherapy Newborn Fluconazole Mycosis Triazole derivatives Extremely low birthweight Colonization
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Summary:	Invasive fungal infections cause substantial morbidity and mortality in preterm infants. In this single-center, double-blind, placebo-controlled trial, extremely-low-birth-weight preterm infants who were given the antifungal agent fluconazole prophylactically for six weeks had significantly lower rates of fungal colonization and systemic fungal infection than control infants, without development of resistance to fluconazole or adverse effects on liver enzymes. The use of fluconazole reduced the incidence of invasive fungal infection in extremely-low-birth-weight infants. Despite aggressive antifungal treatment of invasive candida infection, systemic fungal disease is increasing in prevalence and leads to high rates of illness and death among preterm infants. 1 , 2 Candida species rapidly colonize the skin and mucous membranes of about 60 percent of critically ill neonates and can progress to invasive infection. 2 , 3 Fungal infection accounts for 9 percent of cases of late-onset sepsis in infants who weigh less than 1500 g and is associated with a mortality rate of 28 percent, as compared with 7 percent among infants in whom no infection develops. 1 Critically ill neonates are at an increased . . .
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23
ISSN:	0028-4793 1533-4406
DOI:	10.1056/NEJMoa010494