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Fosfluconazole for antifungal prophylaxis in very low birth weight infants

Daijiro Takahashi1, Tomohiko Nakamura, Reiko Shigematsu

  • 1Department of Pediatrics, School of Medicine, University of Occupational and Environmental Health, Kitakyushu 807-8555, Japan.

International Journal of Pediatrics
|December 1, 2009
PubMed

Insights

Fosfluconazole prophylaxis effectively prevented invasive fungal infections in very low birth weight infants. This antifungal treatment showed good tolerability, with no significant impact on liver or renal function.

Area of Science:

  • Neonatal Medicine
  • Infectious Diseases
  • Pharmacology

Background:

  • Very low birth weight (VLBW) infants are highly susceptible to invasive fungal infections (IFIs).
  • Central vascular catheters increase the risk of IFIs in this vulnerable population.
  • Antifungal prophylaxis is crucial for IFI prevention in VLBW infants.

Purpose of the Study:

  • To evaluate the safety and efficacy of fosfluconazole prophylaxis for preventing IFIs.
  • To assess the tolerability of fosfluconazole in VLBW infants with central vascular access.

Main Methods:

  • Retrospective case series study.
  • Inclusion of 23 VLBW infants receiving intravenous fosfluconazole (6 mg/kg daily) during central venous catheter placement.
  • Monitoring for fungal infections, beta-D-glucan levels, and liver/renal function.

Main Results:

  • No cases of invasive fungal infection were detected during central venous catheter placement.
  • No infants showed elevated beta-D-glucan levels.
  • All infants survived until discharge.
  • No statistically significant differences in liver and renal function were observed before and after prophylaxis.

Conclusions:

  • Fosfluconazole prophylaxis is well-tolerated and effective in preventing IFIs in VLBW infants.
  • This study represents the first report on fosfluconazole use for antifungal prophylaxis in VLBW infants.

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