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Antifungal prophylaxis for very low birthweight infants: UK national survey

L Clerihew1, W McGuire

  • 1Ninewells Hospital and Medical School, Dundee, Scotland.

Archives of Disease in Childhood. Fetal and Neonatal Edition
|September 5, 2007
PubMed

Insights

A UK survey found 28% of neonatal units use antifungal prophylaxis for very low birthweight infants. This practice, especially systemic prophylaxis for extremely preterm infants, shows significant variation, suggesting a need for randomized trials.

Area of Science:

  • Neonatal Medicine
  • Infectious Disease Prevention
  • Clinical Practice Variation

Background:

  • Invasive fungal infections pose a significant risk to very low birthweight infants.
  • Antifungal prophylaxis is utilized in some neonatal units to mitigate this risk.
  • Current practices in antifungal prophylaxis show considerable heterogeneity.

Purpose of the Study:

  • To assess the current use of systemic or topical/oral antifungal prophylaxis in UK neonatal units for very low birthweight infants.
  • To identify the extent of variation in antifungal prophylaxis strategies.
  • To determine the rationale for undertaking randomized trials in this area.

Main Methods:

  • A UK-wide survey of neonatal units was conducted.
  • Data collected focused on the reported use of antifungal prophylaxis (systemic, topical, or oral).
  • The survey specifically targeted very low birthweight infants and those at high risk for invasive fungal infection.

Main Results:

  • Twenty-eight percent (28%) of surveyed neonatal units reported using systemic or topical/oral antifungal prophylaxis.
  • Systemic prophylaxis is often reserved for extremely preterm infants with additional risk factors.
  • Significant variation in prophylactic practices was observed across units.

Conclusions:

  • The observed variation in antifungal prophylaxis practices warrants further investigation.
  • Randomized controlled trials are suggested to evaluate the efficacy and optimal use of antifungal prophylaxis in at-risk neonatal populations.
  • Standardization of evidence-based guidelines for antifungal prophylaxis may be necessary.

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