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Management of neonatal candidiasis. Neonatal Candidiasis Study Group
1Department of Pediatrics, University of Texas Medical Branch, Galveston 77555-0371, USA. jrowen@utmb.edu
The Pediatric Infectious Disease Journal
|December 16, 1998
Summary
Neonatal candidiasis management shows consensus on prompt amphotericin B for positive blood cultures. However, significant controversy exists regarding antifungal choices and treatment duration, highlighting the need for further research in neonatal care.
Area of Science:
- Neonatal Medicine
- Infectious Diseases
- Mycology
Background:
- Neonatal candidiasis is a significant clinical challenge.
- Prompt diagnosis and treatment are crucial for patient outcomes.
Purpose of the Study:
- To survey current practices in neonatal candidiasis management.
- Identify areas of agreement and disagreement among neonatologists and pediatric infectious disease specialists.
Main Methods:
- A questionnaire was distributed to US-based members of the Pediatric Infectious Diseases Society and neonatologists.
- 380 usable responses were analyzed.
Main Results:
- 95% of respondents have treated systemic candidiasis in neonates.
- Amphotericin B is the preferred initial therapy for candidemia (88%), with broad agreement on diagnostic evaluations.
- Disagreement exists regarding fluconazole vs. amphotericin B for candiduria and management of central lines.
Conclusions:
- While prompt amphotericin B for candidemia is widely accepted, significant practice variations exist for other aspects of neonatal candidiasis management.
- Areas lacking consensus include antifungal choices, treatment duration, and management of indwelling catheters.
- Further research is warranted to establish evidence-based guidelines for neonatal candidiasis treatment.