Related Experiment Videos
Prospective study of fluconazole therapy in systemic neonatal fungal infection
S Wainer1, P A Cooper, H Gouws
1Department of Paediatrics, Baragwanath Hospital, University of the Witwatersrand, South Africa.
Background:
Standard neonatal systemic antifungal therapy with amphotericin B and flucytosine can be associated with toxicity, drug resistance and the need for prolonged venous access. There is consequently a need for alternative treatment options.
Objectives:
To assess the efficacy and safety of fluconazole in the treatment of systemic neonatal fungal infections.
Method:
Open, nonrandomized evaluation of fluconazole treatment in 20 consecutively enrolled neonates with systemic fungal infection.
Results:
Clinical and microbiologic cure was achieved in 12 of 19 (63%) of infants treated. One additional infant received prior amphotericin B therapy and is included for assessment of side effects. One infant with Torulopsis glabrata infection failed treatment. Six infants died of Gram-negative bacterial infection and other intercurrent medical problems.
Conclusion:
Fluconazole appeared to be safe and effective for treatment of systemic candidal infection in the neonate although more data are required in very low birth weight infants.
Insights
Fluconazole shows promise as a safe and effective treatment for systemic fungal infections in newborns, offering an alternative to traditional therapies. Further research is needed for very low birth weight infants.
Area of Science:
- Neonatal Medicine
- Infectious Diseases
- Pharmacology
Background:
- Standard neonatal antifungal treatments like amphotericin B and flucytosine present challenges including toxicity, drug resistance, and prolonged IV access.
- Alternative treatment options for systemic neonatal fungal infections are needed.
Purpose of the Study:
- To evaluate the safety and efficacy of fluconazole for treating systemic fungal infections in neonates.
Main Methods:
- An open-label, non-randomized study was conducted.
- Twenty neonates with systemic fungal infections were consecutively enrolled and treated with fluconazole.
Main Results:
- A clinical and microbiological cure was observed in 12 out of 19 (63%) treated infants.
- One infant with Torulopsis glabrata infection did not respond to treatment.
- Six infants expired due to Gram-negative bacterial infections or other concurrent medical issues.
Conclusions:
- Fluconazole appears to be a safe and effective option for treating systemic candidal infections in neonates.
- Additional data are necessary to confirm efficacy and safety in very low birth weight infants.