[Neonatal candidiasis and liposomal amphotericin B treatment: our experience].

OBJECTIVE

Nosocomial Candidiasis in low birth weight (LBW) infants have increased. Toxic side effects limit the use of conventional Amphotericin B for treatment of fungal infections. The liposomal forms have lowered this risk considerably, even at higher doses. Our aim was to evaluate treatment response to liposomal Amphotericin B in neonates with Candidiasis.

PATIENTS AND METHODS

Fifteen neonates diagnosed both clinically and biologically of Candidiasis infection and who were treated with liposomal Amphotericin B from June 1994 through July 1997 were included. Duration of treatment, when culture became negative, secondary effects, complications, other medication, basal pathology and clinical course were analyzed.

RESULTS

Mean gestational age was 36 +/- 6 weeks and 60% were preterm. Mean age at diagnosis was 13.4 days. Eleven patients presented sepsis (1 C. Sp., 9 C. albicans and 1 C. parapsilosis). They were treated with liposomal Amphotericin B, starting dose 0.5-1 mg/kg/day). One patient had associated 5-fluorocytosine. Cultures became negative at approximately 13 days and mean duration of therapy was 21.13 days. Seven patients showed additional bacterial infections. Side effects during treatment were anemia and hypotension.

CONCLUSIONS

Liposomal Amphotericin B has been effective in the treatment of Candidiasis without toxic signs that can be attributed solely to the medication.