Fluconazole Prophylaxis Reduces Infection but Not Mortality or Outcomes of Prematurity

Results of a randomized study do not support expanded use of prophylactic fluconazole in lower-risk populations.

Infections caused by Candida species are the third leading cause of late-onset infection in premature infants. Epidemiologic data indicate that invasive candidiasis is associated with high rates of mortality and long-term morbidity in extremely premature infants (<1000 g), but few clinical trials have evaluated long-term outcomes in populations with low background rates of infection. In this study, researchers randomized 362 extremely low-birth-weight infants (birth weight <750 g; median gestational age, 25 weeks) in U.S. neonatal intensive care units (NICUs) to receive fluconazole prophylaxis or placebo twice weekly for 42 days.

By day 49, significantly fewer infants developed invasive candidiasis in the fluconazole group than in the placeb…

Reviewing Author

Robin Steinhorn, MD

Disclosures

Consultant/Advisory BoardActelion Pharmaceuticals

Editorial BoardsJournal of Pediatrics

Leadership Positions in Professional SocietiesAmerican Pediatric Society (President); American Board of Pediatrics (Board of Directors)

Robin Steinhorn, MD

Disclosures

Consultant/Advisory BoardActelion Pharmaceuticals

Editorial BoardsJournal of Pediatrics

Leadership Positions in Professional SocietiesAmerican Pediatric Society (President); American Board of Pediatrics (Board of Directors)

Fluconazole Prophylaxis Reduces Infection but Not Mortality or Outcomes of Prematurity

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Reviewing Author