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Published on: February 14, 2018
Systemic antifungal prophylaxis for very low birthweight infants: a systematic review
L Clerihew1, N Austin, W McGuire
1Ninewells Hospital and Medical School, Dundee, Scotland.
Archives of Disease in Childhood. Fetal and Neonatal Edition
|September 5, 2007
Insights
Prophylactic fluconazole significantly lowers invasive fungal infections in very low birthweight infants. More research is needed to confirm effects on mortality and development.
Area of Science:
- Neonatal Medicine
- Infectious Diseases
- Pharmacology
Background:
- Very low birthweight infants are highly susceptible to invasive fungal infections (IFIs).
- Early antifungal prophylaxis is a strategy to prevent IFIs in this vulnerable population.
Purpose of the Study:
- To evaluate the efficacy of prophylactic fluconazole in preventing IFIs in very low birthweight infants.
- To synthesize evidence from randomized controlled trials on fluconazole's prophylactic use.
Main Methods:
- Systematic review and meta-analysis of four randomized controlled trials.
- Inclusion criteria focused on very low birthweight infants receiving prophylactic fluconazole.
Main Results:
- Prophylactic fluconazole was associated with a reduced incidence of invasive fungal infections.
- The available data suggest a beneficial effect, but further trials are required.
Conclusions:
- Prophylactic fluconazole appears effective in reducing IFIs in very low birthweight infants.
- Additional research is necessary to precisely determine effect size and evaluate impacts on mortality, neurodevelopment, and antifungal resistance.
Abstract:
Systematic review and meta-analysis of four randomised controlled trials suggest that prophylactic fluconazole reduces the incidence of invasive fungal infection in very low birthweight infants. Further trials are needed to provide more precise estimates of effect size, and to assess the effect on mortality, neurodevelopment and the emergence of antifungal resistance.
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