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KMID : 0869620140310040919
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Journal of Korean Society of Hospital Pharmacists
2014 Volume.31 No. 4 p.919 ~ p.927
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Efficacy of Fluconazole Prophylaxis for Invasive Fungal Infection in Extremely Low Birth Weight Infants
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Lim Hye-Min
Yang Sa-Mi
Park Yun-Hee
Han Hye-Won
Gwak Hye-Sun
Kim Jae-Youn
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Abstract
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Background : An invasive fungal infection (IFI) is an important cause of morbidity and mortality in preterm infants with immature immune systems. In the present study, we evaluated the efficacy in preventing IFI and adverse effects of prophylactic fluconazole in extremely low birth weight infants (ELBWIs).
Methods : From January 2010 to July 2012, we conducted a chart review in a total of 106 preterm infants with a birth weight less than 1 kg that were hospitalized in the neonatal intensive care unit (NICU) of the Asan medical center. In May 2011, an unit policy on fluconazole prophylaxis had been implemented (3 mg/kg twice a week intravenous infusion) and we classified the study population into two groups; control group (admitted before the introduction of fluconazole
prophylaxis, n=71) and study group (admitted after the introduction of fluconazole prophylaxis, n=35). The incidence of IFI and the strains of infection were investigated and other outcome variables including mortality, morbidity, and adverse effects of fluconazole were also collected.
Results : The incidence of IFI was 2.9% in the study group versus 19.7% in the control group (p<0.05). Logistic regression revealed that fluconazole prophylaxis significantly decreased the rates of IFI (Odds ratio 0.082, p<0.05). There was no difference in the incidence of cholestasis between two groups and there was no evidence of hepatotoxicity of fluconazole.
Conclusion : The prophylactic administration of fluconazole in ELBWIs revealed its effectiveness in preventing IFI without significant adverse effects.
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KEYWORD
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Premature infant, Fungal infection, Fluconazole, Prophylaxis
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