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Oral nystatin prophylaxis and neonatal fungal infections

A Howell1, D Isaacs, R Halliday

  • 1Department of Infectious Diseases, Children's Hospital at Westmead, Locked Bag 4001, Westmead, NSW, 2145, Australia.

Archives of Disease in Childhood. Fetal and Neonatal Edition
|March 27, 2009
PubMed

Insights

Antifungal prophylaxis with oral nystatin significantly reduced invasive fungal infections in premature infants. This study found lower infection rates in neonatal units using nystatin compared to those not using it.

Area of Science:

  • Neonatal Medicine
  • Infectious Diseases
  • Pharmacology

Background:

  • Neonatal fungal infections pose a risk, influencing the need for antifungal prophylaxis.
  • The incidence of these infections is a key factor in determining the value of prophylactic treatments.

Purpose of the Study:

  • To compare the incidence of fungal infections in neonatal units with and without oral nystatin prophylaxis.
  • To evaluate the effectiveness of antifungal prophylaxis in preventing neonatal fungal infections.

Main Methods:

  • A prospective, multi-centre surveillance study was conducted from 1993 to 2006.
  • Invasive fungal infections were monitored in infants weighing less than 1500 grams birth weight in Australian and New Zealand neonatal units.
  • Infections were defined by positive blood or cerebrospinal fluid cultures.

Main Results:

  • The overall incidence of invasive fungal infection was 0.80% in infants <1500 g.
  • Units using oral nystatin prophylaxis had a significantly lower incidence (0.54%) compared to units with no prophylaxis (1.23%) (p<0.001).
  • For infants <1000 g, nystatin prophylaxis was associated with a lower incidence (1.23%) versus no prophylaxis (2.67%) (p<0.001).

Conclusions:

  • Neonatal fungal infection incidence was low in Australia and New Zealand.
  • Oral nystatin prophylaxis was linked to a statistically significant reduction in fungal infection rates compared to no prophylaxis.
Abstract

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