Use of prophylactic fluconazole in a neonatal intensive care unit: efficacy is similar to that described in adult high-risk surgical patients

摘要: We read with great interest the recent article by Ho and coworkers [1] concerning use of prophylactic fluconazole in high-risk surgical patients, which those authors reported on seven randomized controlled studies from Cochrane Controlled Trial Register. colleagues concluded that immunocompetent patients is associated a reduced incidence candidaemia, fewer requiring systemic amphotericin B as rescue therapy for fungal infection, no increase proportion colonized or infected fluconazole-resistant fungi, but only trend toward reduction hospital mortality. In addition to considered [1], preterm neonates neonatal intensive care unit are at increased risk colonization infection – despite positive reports limited number institutions including ours [2-4] these subsets not yet viewed standard [5]. Nevertheless, our tertiary we began 2001 all birth weight less than 1500 g, findings fully consistent data colleagues. In particular, when analyzed decade 1996 2005 compared period 2001–2005 5-year before introduction prophylaxis (388 versus 345 respectively), found significant reductions (any site: 45.2% 23.9%, 95% confidence interval 0.265–0.608; P < 0.0001), (from 16.1% 4.6%, 0.135–0.498; 0.0001) rates progression 0.36 0.18, 0.148–0.802; = 0.01), infants (10/345 11/388; 0.45) (5/345 4/388; 0.35) fungi. Similarly coworkers, overall mortality was significantly 11.8% 10.4%; 0.29); however, treated were more likely survive who (mortality rate 4.1% 17.7%, 0.039–0.778; 0.008). Our confirm effectiveness strategy administering population other most frequently described (i.e. patients), suggest extension this policy settings warranted.