Fluconazole therapy in neonatal candidemia

Y. C. Huang, T. Y. Lin, R. I. Lien, Y. H. Chou, C. Y. Kuo, P. H. Yang, W. S. Hsieh

Research output: Contribution to journalArticlepeer-review

22 Citations (Scopus)

Abstract

We reviewed 62 episodes (from 59 infants) of neonatal candidemia that occurred between January 1994 and June 1999. Except 5 term babies, all infants were premature (median gestational age [GA], 30 weeks) and birth weight was less than 2500 g (median, 1300 g). Most infants had reported risk factors and other neonatal problems. The age at onset of candidemia ranged from 15 to 173 days with a median of 34 days. In addition to catheter removal, all but one infants received antifungal agents and candidemia was eradicated subsequently in 46 episodes (75%). Eighteen infants with 19 episodes ever received fluconazole therapy. Fluconazole was administered as the first line agent in 6 episodes and successfully cleared candidemia in 5 episodes. Fluconazole was used as an alternative agent in an additional 13 episodes after amphotericin B (am B) ± flucytosine were given for a period without a satisfactory result and eradication of candidemia was achieved in 8 episodes subsequently. All 18 infants tolerated fluconazole well and no withdrawal was required on account of its adverse effect. In contrast, am B alone was administered as the first line agent in 55 episodes and successfully cleared candidemia in 32 episodes (58%). This retrospective analysis suggests that fluconazole appears to be safe in neonates and can be used as an alternative agent in treating neonatal candidemia. A large-scaled prospective study may be needed.

Original languageEnglish
Pages (from-to)411-415
Number of pages5
JournalAmerican Journal of Perinatology
Volume17
Issue number8
DOIs
Publication statusPublished - 2000
Externally publishedYes

Keywords

  • Candidemia
  • Fluconazole
  • Neonate

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynaecology

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