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Fungal prophylaxis in neonates: a review article
Tyner R Lollis1, Wanda T Bradshaw
1Duke University School of Nursing, Durham, North Carolina (Mss Lollis and Bradshaw); Novant Health Presbyterian Medical Center, Charlotte, North Carolina (Ms Lollis); and Duke University Health System, Durham, North Carolina (Ms Bradshaw).
Summary
Fungal infections (fungemia) are a significant threat to premature infants in neonatal intensive care units. Intravenous fluconazole is the preferred prophylactic drug for these vulnerable infants.
Area of Science:
- Neonatal Medicine
- Infectious Diseases
- Pharmacology
Background:
- Fungemia poses a critical, often fatal risk to premature infants in neonatal intensive care units globally.
- Invasive fungal infections require prophylactic strategies, with various oral and intravenous medications explored.
Purpose of the Study:
- To identify the optimal chemoprophylactic agent for preventing invasive fungal infections in preterm infants.
Main Methods:
- Review of prophylactic antifungal drug options used in neonatal intensive care units.
- Evaluation of oral nystatin, intravenous fluconazole, and intravenous amphotericin B for preterm infants.
Main Results:
- Intravenous fluconazole has demonstrated efficacy in preventing fungal infections in this high-risk population.
- Previous prophylactic methods showed some success but were not universally optimal.
Conclusions:
- Intravenous fluconazole is identified as the leading choice for chemoprophylaxis against invasive fungal infections in premature infants.
- Targeted antifungal prophylaxis is crucial for improving outcomes in neonatal intensive care units.
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