Fluconazole Therapy in Neonatal Candidemia
Resource
AMERICAN JOURNAL OF PERINATOLOGY v.17 n.8 pp.411-415
Journal
AMERICAN JOURNAL OF PERINATOLOGY
Journal Volume
v.17
Journal Issue
n.8
Pages
411-415
Date Issued
2000
Date
2000
Author(s)
Huang, Yhu-Chering
Lin, Tzou-Yien
Lien, Rey-In
Chou, Yi-Hong
Kuo, Chii-Yuh
Yang, Peng-Hong
Hsieh, Wu-Shiun
Abstract
We reviewed 62 episodes (from 59 infants) of neonatal candidemia that occurred between January 1994 and June 1999. Except 5 term babies, all infants were premature (median gestational age [GA], 30 weeks) and birth weight was less than 2500 g (median, 1300 g). Most infants had reported risk factors and other neonatal problems. The age at onset of candidemia ranged from 15 to 173 days with a median of 34 days. In addition to catheter removal, all but one infants received antifungal agents and candidemia was eradicated subsequently in 46 episodes (75%). Eighteen infants with 19 episodes ever received fluconazole therapy. Fluconazole was administered as the first line agent in 6 episodes and successfully cleared candidemia in 5 episodes. Fluconazole was used as an alternative agent in an additional 13 episodes after amphotericin B (am B) +/- flucytosine were given for a period without a satisfactory result and eradication of candidemia was achieved in 8 episodes subsequently. All 18 infants tolerated fluconazole well and no withdrawal was required on account of its adverse effect. In contrast, am B alone was administered as the first line agent in 55 episodes and successfully cleared candidemia in 32 episodes (58%). This retrospective analysis suggests that fluconazole appears to be safe in neonates and can be used as an alternative agent in treating neonatal candidemia. A large-scaled prospective study may be needed.
Subjects
fluconazole
neonate
candidemia
INTENSIVE-CARE UNIT
AMPHOTERICIN-B
RANDOMIZED TRIAL
Type
journal article