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[Neonatal candidiasis and liposomal amphotericin B treatment: our experience]
P Carrasco Sánchez1, M L Castillo Montero, A Bejarano Palma
1Unidad de Neonatología, Hospital Universitario Virgen Macarena, Sevilla.
Objective:
Nosocomial Candidiasis in low birth weight (LBW) infants have increased. Toxic side effects limit the use of conventional Amphotericin B for treatment of fungal infections. The liposomal forms have lowered this risk considerably, even at higher doses. Our aim was to evaluate treatment response to liposomal Amphotericin B in neonates with Candidiasis.
Patients And Methods:
Fifteen neonates diagnosed both clinically and biologically of Candidiasis infection and who were treated with liposomal Amphotericin B from June 1994 through July 1997 were included. Duration of treatment, when culture became negative, secondary effects, complications, other medication, basal pathology and clinical course were analyzed.
Results:
Mean gestational age was 36 +/- 6 weeks and 60% were preterm. Mean age at diagnosis was 13.4 days. Eleven patients presented sepsis (1 C. Sp., 9 C. albicans and 1 C. parapsilosis). They were treated with liposomal Amphotericin B, starting dose 0.5-1 mg/kg/day). One patient had associated 5-fluorocytosine. Cultures became negative at approximately 13 days and mean duration of therapy was 21.13 days. Seven patients showed additional bacterial infections. Side effects during treatment were anemia and hypotension.
Conclusions:
Liposomal Amphotericin B has been effective in the treatment of Candidiasis without toxic signs that can be attributed solely to the medication.
Insights
Liposomal Amphotericin B effectively treated Candidiasis in low birth weight infants. This antifungal treatment showed efficacy without significant toxic side effects in neonates.
Area of Science:
- Neonatal Medicine
- Infectious Diseases
- Pharmacology
Background:
- Nosocomial Candidiasis is a growing concern in low birth weight (LBW) infants.
- Conventional Amphotericin B has toxic side effects, limiting its use.
- Liposomal formulations of Amphotericin B reduce toxicity, allowing for higher doses.
Purpose of the Study:
- To evaluate the treatment response to liposomal Amphotericin B in neonates diagnosed with Candidiasis.
- To assess the safety and efficacy of liposomal Amphotericin B in this vulnerable population.
Main Methods:
- A retrospective analysis of 15 neonates with clinically and biologically confirmed Candidiasis treated with liposomal Amphotericin B between June 1994 and July 1997.
- Data collected included treatment duration, time to negative cultures, side effects, complications, and clinical outcomes.
Main Results:
- The study included 15 neonates, with a mean gestational age of 36 weeks; 60% were preterm.
- Eleven patients presented with sepsis caused by various Candida species.
- Cultures became negative around day 13, with a mean treatment duration of 21.13 days. Observed side effects included anemia and hypotension.
Conclusions:
- Liposomal Amphotericin B demonstrated effectiveness in treating neonatal Candidiasis.
- The treatment was associated with minimal toxic signs attributable solely to the medication, suggesting an improved safety profile.