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Candida colonization occurs in up to 60% of very-low-birth-weight infants during care in newborn intensive care units (NICUs), and up to 20% of these neonates develop invasive candida infections. Previously, two small, single-center trials and four retrospective observational studies showed that fluconazole helps to prevent fungal colonization and infection in premature infants (Journal Watch Infectious Diseases Dec 21 2001). Now, in a larger, manufacturer-sponsored trial, researchers have evaluated fluconazole prophylaxis at eight tertiary care NICUs in Italy.
During a 15-month period, 322 very-low-birth-weight infants admitted to the NICU before day 3 of life were randomized to receive placebo or either 6 mg/kg or 3 mg/kg of fluconazole ev…