Prophylactic fluconazole is effective in preventing fungal colonization and fungal systemic infections in preterm neonates: a single-center, 6-year, retrospective cohort study.

摘要: OBJECTIVE. Despite the promising preliminary results observed in extremely low birth weight (ELBW) populations, use of fluconazole to prevent fungal colonization and infection preterm neonates NICU is still an open question not yet recommended as a standard care. We have reviewed our 6-year series assess effectiveness safety this form prophylaxis. METHODS. This retrospective study consisted 465 who weighed n = 240) were compared with those born between 2001 2003 treated until 30th day life (45th for 225). Weekly surveillance cultures obtained from all patients. Incidence colonization, incidence systemic (SFI), rate progression infection, mortality rates attributable fungi calculated both groups separately RESULTS. Overall was significantly lower group B (24.0%) than A (43.8%; relative risk [RR]: 0.406; 95% confidence interval [CI]: 0.273–0.605). The same true multiple sites (2.6% vs 5.8%) high-risk (5.8% 19.2%). SFI (10 225 cases; 4.4%) (40 240 16.7%; RR: 0.233; CI: 0.113–0.447). Reduction greater ELBW also significant NE-VLBW neonates. Rate (0.17 0.38; 0.369; 0.159–0.815). Crude Candida species 1.7% (4 0% (0 225) B. (any cause before hospital discharge) similar two (11.2% 10.6%), but colonized infants ( 159), it (3.7% 18.1%; 0.174; 0.039–0.778). natively fluconazole-resistant did increase over years, patterns sensitivity remained same. No adverse reaction related occurred. CONCLUSIONS. Prophylactic reduces by decreases initial massive infection. All VLBW may benefit