The Efficacy of Fluconazole Prophylaxis on Invasive Candidiasis Infection in Extremely Low Birth Weight Neonates

Document Type: Original Article

Authors

1 Maternal, fetal & Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran.

2 Breastfeeding Research Center, Tehran University of Medical Sciences, Tehran, Iran

3 Maternal,Fetal & Neonatal Research Center-TUMS

4 Maternal, fetal & Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran

5 Maternal, fetal & Neonatal Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Abstract

Backgroaund: Invasive candidiasis infection is one of the main life-threatening problems for
extremely low birth weight neonates who are in neonatal intensive care unit. Candidiasis can
cause mortality, short term morbidity and long term neurodevelopmental outcome in infected
infants who survive, therefore since several years ago fluconazole prophylaxis has begun for
premature infants who were admitted to intensive care units in some parts of the world.
Methods: In this retrospective cohort, the population study who were all infants less than 1,000
gram admitted to Vali-Asr Hospital during the years 2011-2016, were divided into two groups:
The first group didn’t receive any fluconazole prophylaxis, and for the second group intravenous
fluconazole was administered. Finally, we compared the incidence of candidiasis between the
two groups.
Results: Fluconazole was administered to 70 out of 167 neonates. 2 neonates of the prophylaxis group (2.9%) and 2 (1.2%) of the non-prophylaxis group were infected with Candida species.The difference between the two groups was not statistically significant (P=0.501). Among the risk factors, bacterial sepsis, duration of central catheter installation and total parenteral nutrition,meropenem or vancomycin administration and hospitalization costs were significantly related to the incidence of invasive candidiasis infection.
Conclusion: The incidence of candidiasis in our study was 2.39% and fluconazole prophylaxis
has not been effective in reducing fungal infections, so further investigations in larger sizes with
different study settings and variety of methodology are needed to evaluate the efficacy of fluconazole prophylaxis on invasive candidiasis infection in extremely low birth weight
neonates.

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