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Candida species have emerged as a major pathogen in tiny preterm infants. Colonization is common and leads to invasive disease because of these infants' immature immune systems, their permeable skin and mucosal barriers, and their need for central vascular access. No proven methods of prevention exist, but these investigators hypothesized that antifungal prophylaxis would reduce colonization and, therefore, invasive infections. In a prospective, randomized trial, 50 infants of <1000 g birthweight received fluconazole, dosed by weight and postnatal age, and 50 received placebo, for 6 weeks. Cultures from tracheal secretions, nasopharynx, skin, and rectum were obtained initially and then weekly. Normally sterile body fluids were cultured when…