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Fluconazole therapy in neonatal candidemia.
1Division of Pediatric Infectious Diseases, Chang Gung Children's Hospital, Chang Gung University, Taoyuan, Taiwan.
American Journal of Perinatology
|January 6, 2001
Summary
Fluconazole is a safe and effective alternative for treating neonatal candidemia in premature infants. This antifungal agent demonstrated good tolerability and successful eradication rates, suggesting its utility in clinical practice.
Area of Science:
- Neonatal Medicine
- Infectious Diseases
- Pharmacology
Background:
- Neonatal candidemia is a serious bloodstream infection primarily affecting premature infants.
- Risk factors and other neonatal complications are common in affected infants.
- Established treatments like amphotericin B have limitations.
Purpose of the Study:
- To evaluate the safety and efficacy of fluconazole in treating neonatal candidemia.
- To compare fluconazole's outcomes with amphotericin B in this population.
- To assess fluconazole's role as a first-line or alternative agent.
Main Methods:
- Retrospective analysis of 62 episodes of neonatal candidemia in 59 infants (1994-1999).
- Data collection included infant characteristics, risk factors, treatment regimens, and outcomes.
- Comparison of fluconazole therapy versus amphotericin B monotherapy.
Main Results:
- Candidemia was eradicated in 75% of cases with antifungal treatment.
- Fluconazole, used in 19 episodes, showed high efficacy as both a first-line and alternative agent.
- Amphotericin B monotherapy achieved a 58% eradication rate.
- Fluconazole was well-tolerated with no adverse effect-related withdrawals.
Conclusions:
- Fluconazole is a safe and effective option for treating neonatal candidemia.
- It can be considered as an alternative agent, particularly when amphotericin B is insufficient.
- Further large-scale prospective studies are warranted to confirm these findings.