Infectious Disease Unit, Gaslini Institute, Genova, Italy.
Early Hum Dev. 2012 May;88 Suppl 2:S11-5. doi: 10.1016/S0378-3782(12)70005-1.
Fluconazole is a triazole antifungal agent that is widely used in the nursery. It is available in both intravenous and oral formulation, and is active against most of the fungal pathogens that require treatment when retrieved from culture samples in neonatal intensive care units. Although clinical use has been wide for over 15 years, there have been small safety and efficacy studies completed in young infants. Randomised clinical trials assessing effectiveness of this agent in prevention of systemic fungal infections in neonates have been published in the last decade, and one large additional randomised study has been recently completed. Nevertheless, a certain degree of uncertainty still exists regarding the kinetics and appropriate dosing of this agent in premature and term infants, as well as regarding safety. Areas of poignant debate include the feasibility of loading dose strategies, appropriate dosages in the early days of life in the different subgroups of preterm infants, and long-term safety of fluconazole administered in prophylaxis during the first weeks of life in extremely premature infants. This paper reviews the most recent evidence on fluconazole and its role in the NICU settings.
氟康唑是一种三唑类抗真菌药物，在儿科中广泛应用。它有静脉注射和口服两种剂型，对从新生儿重症监护病房的培养样本中检出的大多数需要治疗的真菌病原体都有效。尽管该药物已在临床上应用了 15 年以上，但在婴幼儿中完成的安全性和疗效研究很少。在过去十年中，已经发表了评估该药物在预防新生儿系统性真菌感染方面的有效性的随机临床试验，最近还完成了一项大型的额外随机研究。然而，关于早产儿和足月儿中该药物的药代动力学和适当剂量，以及安全性，仍然存在一定程度的不确定性。争论的焦点包括负荷剂量策略的可行性、不同早产儿亚组生命早期的适当剂量以及在极早产儿生命早期预防中使用氟康唑的长期安全性。本文综述了氟康唑及其在新生儿重症监护病房中的作用的最新证据。
