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Fluconazole prophylaxis in preterm infants: a systematic review.
Juliana Ferreira da Silva Rios1, Paulo Augusto Moreira Camargos2, Luísa Petri Corrêa1
1Universidade Federal de Minas Gerais, Santa Efigênia, BH, Brazil.
Summary
Antifungal prophylaxis with intravenous fluconazole significantly reduces Invasive Candidiasis and Candida colonization in premature newborns. This review highlights fluconazole
Area of Science:
- Neonatal Medicine
- Infectious Diseases
- Pharmacology
Background:
- Invasive Candidiasis is a serious threat to premature newborns.
- Antifungal prophylaxis is a potential strategy to reduce its incidence.
Purpose of the Study:
- To review the efficacy of intravenous fluconazole prophylaxis in preventing Invasive Candidiasis in premature infants.
- To assess the impact of fluconazole on Candida colonization and mortality.
Main Methods:
- Systematic review of studies from major databases (PubMed, Scopus, Cochrane, etc.).
- Keywords included: Antifungal, Candida, Fluconazole prophylaxis, Preterm infants.
- Evaluated outcomes: Invasive Candidiasis incidence, Candida colonization, mortality.
Main Results:
- Eleven of twelve studies showed a significant reduction in Invasive Candidiasis with fluconazole prophylaxis compared to placebo or no prophylaxis.
- Four of five studies reported a statistically significant lower proportion of Candida colonization in infants receiving fluconazole.
- One study indicated a significant reduction in mortality favoring fluconazole use.
Conclusions:
- Intravenous fluconazole prophylaxis is effective in reducing the incidence of Candida colonization and invasive fungal disease in premature newborns.
- The decision to use fluconazole should weigh benefits against risks, including incidence of candidiasis, mortality, drug safety, and potential for resistance.
