Division of Neonatology, Department of Pediatrics, Wayne State University, Detroit, MI, USA.
J Perinatol. 2012 Jan;32(1):21-6. doi: 10.1038/jp.2011.27. Epub 2011 Jul 14.
The objective of this study was to evaluate the efficacy of targeted intermittent fluconazole prophylaxis (FP) to high-risk preterm (PT) infants.
Observational pre-post cohort study (n=524). Targeted FP (3 mg kg(-1)) was administered to PT infants (birth weights <1500 g and <6 weeks of age) who received broad-spectrum antibiotics for more than 2 days and had at least one additional risk factor for invasive candidiasis during the antibiotic administration period.
Invasive candidiasis decreased significantly from 15.3 to 6.2% during the FP period. Duration of parenteral nutrition (15.5 vs 19.2 days), central line (12.7 vs 15.8 days) and necrotizing enterocolitis rates (7 vs 9.5%) were significantly higher in the FP period. FP was administered to 89 (31.3%) infants; the median (range) number of doses was four (1 to 24) and duration was 7 (1 to 38) days.
In the current study, targeted intermittent FP to a selected population of PT infants was efficacious in reducing the rate of invasive candidiasis, compared with historical controls.
本研究旨在评估针对高危早产儿（PT）的目标性氟康唑预防（FP）的疗效。
观察性前后队列研究（n=524）。FP（3mg/kg）用于接受广谱抗生素治疗超过 2 天且在抗生素治疗期间有至少一个侵袭性念珠菌病额外危险因素的 PT 婴儿（出生体重<1500g 和<6 周龄）。
FP 期间侵袭性念珠菌病的发生率从 15.3%显著降至 6.2%。FP 期间，静脉营养（15.5 天比 19.2 天）、中心静脉置管（12.7 天比 15.8 天）和坏死性小肠结肠炎的发生率（7%比 9.5%）显著更高。89 名（31.3%）婴儿接受了 FP；中位（范围）剂量数为 4（1 至 24），持续时间为 7（1 至 38）天。
与历史对照相比，在当前研究中，针对选定的 PT 婴儿人群进行的目标性间歇性 FP 可有效降低侵袭性念珠菌病的发生率。
