Therapeutic treatment of systemic candidiasis in newborns

This report details the management of a group of newborns who had a diagnosis of systemic Candida albicans septicemia. All the infants were extremely preterm (29 weeks' gestation or less) and had predisposing factors to disseminated fungal infections. Diagnosis was made by cultures from blood, urine, and from the tip of indwelling catheters. Therapy was based in all the infants on the combination of amphotericin B (Amph. B) and 5-fluorocytosine (5FC). Amph. B was intravenously administrated at a test dose of 0.1 mg/kg which if tolerated, was increased with scalar doses until a maximum of 0.35-0.50 mg/kg/die. 5FC was intravenously or orally administered at a 100-200 mg/kg/die dose. Time of treatment with Amph B was prolonged from 13 to 30 days and that with 5FC from 11 to 40 days. In two infants there was an increase of transaminases and Gamma GT and no infant had signs of nephrotoxicity. The high therapeutic success (75% of cases) confirms the validity of the utilized therapeutic schemes.