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Fluconazole prophylaxis in high-risk, very low birth weight infants  

Kim, Soo Young (Department of Pediatrics, School of Medicine, Chonnam National University)
Lee, Soon Joo (Department of Pediatrics, School of Medicine, Chonnam National University)
Kim, Mi Jeong (Department of Pediatrics, School of Medicine, Chonnam National University)
Song, Eun Song (Department of Pediatrics, School of Medicine, Chonnam National University)
Choi, Young Youn (Department of Pediatrics, School of Medicine, Chonnam National University)
Publication Information
Clinical and Experimental Pediatrics / v.50, no.7, 2007 , pp. 636-642 More about this Journal
Abstract
Purpose : Fluconazole prophylaxis for very low birth weight (VLBW) infants has been shown to reduce invasive fungal infection and its mortality. This study aims to evaluate the effect of fluconazole prophylaxis in VLBW infants on the incidence and mortality of fungal infection. Methods : VLBW infants with endotracheal intubation and central vascular access admitted to the Neonatal Intensive Care Unit (NICU) at Chonnam University Hospital were enrolled. Twenty eight infants of 7-month baseline period from January to July 2005 ('non-fluconazole group') were compared with 29 infants of a 7-month fluconazole period from January to July 2006 ('fluconazole group'). Results : Gestational age, birth weight, sex, mode of delivery, frequency of twin pregnancy, chorioamnionitis, antenatal steroid and rupture of membranes were similar between the fluconazole and non-fluconazole groups. The rate of extremely low birth weight (ELBW) infants, frequency and duration of prophylactic antibiotics, total parenteral nutrition and umbilical catheters, duration of intralipid, mechanical ventilation and nasal continuous positive airway pressure (CPAP) were also not significant. However, frequency of percutaneous central venous catheterization (PCVC) and intralipid administration, and duration of PCVC were significant between the two groups. The overall incidence and mortality of fungal infection were not different between the two groups. Although the Malassezia infection was increased in the fluconazole group (P<0.05), candida was significantly decreased compared to the non-fluconazole group (P<0.05). Conclusion : Fluconazole prophylaxis in high risk VLBW infants decreased the candida infection significantly. Antifungal prophylaxis is recommended in terms of cost effectiveness, but further study is needed to clarify the reason for the increase of Malassezia infection.
Keywords
Fluconazole prophylaxis; Very low birth weight infants; Fungal infection;
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