Related Experiment Video

Updated: Jun 7, 2026

Isolation of Neonatal Extrahepatic Cholangiocytes
07:54

Isolation of Neonatal Extrahepatic Cholangiocytes

Published on: June 5, 2014

Twice-weekly fluconazole prophylaxis in premature infants: association with cholestasis

Vishwanath Bhat1, Milliecor Fojas, Judy G Saslow

  • 1Pediatrics/Neonatology, Cooper University Hospital-Robert Wood Johnson Medical School, Camden, New Jersey 08103, USA.

Pediatrics International : Official Journal of the Japan Pediatric Society
|November 3, 2010
PubMed

Insights

Less frequent dosing (LFD) fluconazole prophylaxis effectively prevents invasive fungal infections in extremely low-birthweight infants. This LFD schedule also reduced the severity of cholestasis, a known side effect of fluconazole.

Area of Science:

  • Neonatalogy
  • Pediatric Infectious Diseases
  • Clinical Pharmacology

Background:

  • Fluconazole prophylaxis is established for preventing invasive candidiasis in extremely low-birthweight (ELBW) infants.
  • Previous findings indicated an increased incidence of cholestasis with standard fluconazole dosing in ELBW infants.
  • This led to the adoption of a less frequent dosing (LFD) schedule (twice weekly) at the institution.

Purpose of the Study:

  • To evaluate the effectiveness of the LFD fluconazole regimen in preventing invasive candidiasis in ELBW infants.
  • To assess the safety profile of the LFD fluconazole regimen, specifically regarding the incidence and severity of cholestasis.

Main Methods:

  • A comparative study design was employed, comparing ELBW infants on the LFD fluconazole regimen (twice weekly for up to 6 weeks) with those on a frequent dosing (FD) schedule.
  • Infants were analyzed for baseline demographics, risk factors for candidiasis, rates of invasive fungal infection, and incidence/severity of cholestasis.

Main Results:

  • No significant difference was found in the incidence of invasive candidiasis between the LFD (2%) and FD (0%) groups (P=0.4).
  • The LFD schedule demonstrated a trend towards decreased incidence of cholestasis.
  • A notable reduction in the severity of cholestasis was observed in infants receiving the LFD regimen.

Conclusions:

  • The LFD fluconazole prophylaxis regimen is effective in preventing invasive fungal infections in ELBW infants.
  • The LFD schedule is associated with decreased severity of cholestasis compared to the FD schedule.
  • This LFD regimen offers a potentially safer alternative for fungal infection prophylaxis in this vulnerable population.
Abstract

More Related Videos

Optimized LC-MS/MS Method for the High-throughput Analysis of Clinical Samples of Ivacaftor, Its Major Metabolites, and Lumacaftor in Biological Fluids of Cystic Fibrosis Patients06:14

Optimized LC-MS/MS Method for the High-throughput Analysis of Clinical Samples of Ivacaftor, Its Major Metabolites, and Lumacaftor in Biological Fluids of Cystic Fibrosis Patients

Published on: October 15, 2017

Implementation of Non-invasive Point of Care Transient Elastography for Evaluation of Liver Disease in Pediatric Populations with Cystic Fibrosis05:56

Implementation of Non-invasive Point of Care Transient Elastography for Evaluation of Liver Disease in Pediatric Populations with Cystic Fibrosis

Published on: August 29, 2025

Related Concept Videos

Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
Drug Dosing: Infants and Children01:29

Drug Dosing: Infants and Children

Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
Cystic Fibrosis: Management01:24

Cystic Fibrosis: Management

Cystic fibrosis (CF) is an autosomal recessive disorder that predominantly affects individuals of Northern European descent, occurring at a rate of 1 in 3500. It is caused by a genetic mutation in a gene on chromosome 7, most commonly the ΔF508 mutation, that codes for the cystic fibrosis transmembrane conductance regulator (CFTR) protein. This results in thicker mucus secretions and obstruction pathologies in multiple organs, including the lungs and sinuses.
Sinus disease and chronic sinusitis...
Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption01:23

Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption

Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...
Pharmacokinetics in Pediatric Patients: Drug Metabolism01:24

Pharmacokinetics in Pediatric Patients: Drug Metabolism

In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses a challenge in...
Cryptococcal Meningitis01:27

Cryptococcal Meningitis

Cryptococcal meningitis is a life-threatening opportunistic infection predominantly associated with HIV/AIDS, accounting for over 100,000 deaths annually worldwide. However, it also affects individuals with other forms of immunosuppression, including those undergoing immunosuppressive therapy, organ transplant recipients, patients with innate immunodeficiencies, and individuals with hematological disorders. The infection is caused mainly by Cryptococcus neoformans and Cryptococcus gattii,...