Prophylactic oral antifungal agents to prevent systemic candida infection in preterm infants

摘要: Background Systemic fungal infection has increased in prevalence neonatal intensive care units (NICU) caring for very low birth weight infants. It is associated with a prolonged stay and an increase morbidity mortality. An assessment of the use oral prophylactic antifungals to prevent systemic needed. Objectives To assess whether administration antifungal agents preterm infants reduces occurrence infection. Search strategy The standard methods Cochrane Collaboration its Neonatal Review Group were used. Searches carried out up July 2003 on Central Register Controlled Trials (CENTRAL, The Library Issue 2, 2003), MEDLINE from 1966, EMBASE 1980, CINAHL 1992. Abstracts SPR (1993 - 2003) ESPR (1995 2002) hand searched. Selection criteria Randomized quasi randomized controlled trials or which agent was compared placebo no treatment another agent Data collection analysis Data extracted using Group, separate evaluation trial quality data extraction undertaken by each author. Results reported relative risk (RR) difference (RD) weighted mean (WMD). 95% confidence intervals reported. Main results We identified three eligible trials, one comparing nystatin (67 infants), miconazole (600 fluconazole (21 infants). As two clinically quite different, meta-analysis not performed. In versus treatment, significantly reduced [RR 0.19 (0.04,0.78)] group treated nystatin. study there significant effect 1.32 (0.46,3.75)]. Neither found mortality, number days received ventilation stayed unit. small nystatin, 0.17 (0.01, 2.84)] mortality reported. Adverse drug reactions any study. Authors' conclusions There insufficient evidence support Randomised current practice settings are needed, other including side effects, order determine have role preventing infections