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Impact of ‘targeted’ fluconazole prophylaxis for preterm neonates: efficacy of a highly selective approach?

Journal of Perinatology volume 32, pages 21–26 (2012)Cite this article

Abstract

Objective:

The objective of this study was to evaluate the efficacy of targeted intermittent fluconazole prophylaxis (FP) to high-risk preterm (PT) infants.

Study Design:

Observational pre–post cohort study (n=524). Targeted FP (3 mg kg−1) was administered to PT infants (birth weights <1500 g and <6 weeks of age) who received broad-spectrum antibiotics for more than 2 days and had at least one additional risk factor for invasive candidiasis during the antibiotic administration period.

Result:

Invasive candidiasis decreased significantly from 15.3 to 6.2% during the FP period. Duration of parenteral nutrition (15.5 vs 19.2 days), central line (12.7 vs 15.8 days) and necrotizing enterocolitis rates (7 vs 9.5%) were significantly higher in the FP period. FP was administered to 89 (31.3%) infants; the median (range) number of doses was four (1 to 24) and duration was 7 (1 to 38) days.

Conclusion:

In the current study, targeted intermittent FP to a selected population of PT infants was efficacious in reducing the rate of invasive candidiasis, compared with historical controls.

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Authors and Affiliations

  1. Division of Neonatology, Department of Pediatrics, Wayne State University, Detroit, MI, USA

    A Martin, A Pappas, M Lulic-Botica & G Natarajan

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  1. A Martin
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  2. A Pappas
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  3. M Lulic-Botica
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  4. G Natarajan
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Correspondence to G Natarajan.

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Supplementary Information accompanies the paper on the Journal of Perinatology website

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Martin, A., Pappas, A., Lulic-Botica, M. et al. Impact of ‘targeted’ fluconazole prophylaxis for preterm neonates: efficacy of a highly selective approach?. J Perinatol 32, 21–26 (2012). https://doi.org/10.1038/jp.2011.27

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