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Pediatr Int. 2011 Aug;53(4):475-9. doi: 10.1111/j.1442-200X.2010.03286.x.

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

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

Abstract

BACKGROUND:

Fluconazole prophylaxis is effective in preventing invasive candidiasis in extremely low-birthweight (ELBW) infants. The authors previously reported an increased incidence of cholestasis with fluconazole prophylaxis in ELBW infants, which led to fluconazole prophylaxis being changed to a less frequent dosing (LFD) schedule of twice a week at their institution. The purpose of the present study was therefore to evaluate the effectiveness and safety of LFD fluconazole prophylaxis in preventing invasive candidiasis in ELBW infants.

METHODS:

ELBW infants who received the LFD regimen of fluconazole (twice a week for up to 6 weeks) were compared with infants who received the frequent dosing (FD) schedule (every 72 h for first 2 weeks, every 48 h for next 2 weeks and every 24 h for the final 2 weeks). The two groups were compared for baseline demographics, risk factors for candidiasis, the rate of invasive fungal infection and the incidence and severity of cholestasis.

RESULTS:

There was no significant difference in the incidence of invasive candidiasis in infants who received the LFD (2/104, 2%) compared to FD (0/140, 0%; P= 0.4) fluconazole prophylaxis. The severity of cholestasis was lower and a trend towards decreased incidence of cholestasis was observed on the LFD schedule.

CONCLUSION:

The LFD regimen of fluconazole prophylaxis is effective in preventing invasive fungal infection in ELBW infants. The severity of cholestasis was decreased with the LFD schedule.

© 2011 The Authors. Pediatrics International © 2011 Japan Pediatric Society.

PMID:
21040197
[PubMed - indexed for MEDLINE]
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