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Am J Perinatol 2000; 17(8): 411-416
DOI: 10.1055/s-2000-13454
Copyright © 2000 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

FLUCONAZOLE THERAPY IN NEONATAL CANDIDEMIA

Yhu-Chering Huang1 , Tzou-Yien Lin1 , Rey-In Lien2 , Yi-Hong Chou2 , Chii-Yuh Kuo2 , Peng-Hong Yang2 , Wu-Shiun Hsieh2
  • 1Division of Pediatric Infectious Diseases, Chang Gung Children's Hospital, Chang Gung University, Taoyuan, Taiwan
  • 2Neonatology, Chang Gung Children's Hospital, Chang Gung University, Taoyuan, Taiwan
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Publication Date:
31 December 2000 (online)

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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.

KEYWORD

Fluconazole - neonate - candidemia

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