WESTPORT, CT (Reuters Health) – When given during the first 6 weeks of life, fluconazole effectively prevents fungal colonization and invasive fungal infections in extremely low-birthweight infants, according to a report in the December 6th issue of The New England Journal of Medicine.
Dr. David Kaufman and colleagues, from the University of Virginia in Charlottesville, assessed the outcomes of 100 preterm infants who were randomized in a double-blind protocol to receive a 6-week course of IV fluconazole or placebo. All of the infants weighed less than 1000 g at birth.
Fungal colonization was significantly less common in the fluconazole group than in the placebo group (p = 0.002). Similarly, fluconazole-treated infants were less likely to develop an invasive fungal infection (p = 0.008).
Neither treatment regimen was associated with the development of fluconazole-resistant organisms, the authors state. Furthermore, no adverse effects were noted with fluconazole therapy.
The current findings suggest that fluconazole prophylaxis has the potential to reduce the substantial morbidity and mortality associated with invasive fungal infection in preterm infants, the investigators point out.
All of the infants required vascular access or endotracheal intubation only during the first 6 weeks of life. It is unclear how effective the fluconazole regimen will be for infants who require these modalities beyond 6 weeks of age, the researchers note.
N Engl J Med 2001;345:1660-1666.
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