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早产婴儿的氟康唑预防：一项系统评价。

Fluconazole prophylaxis in preterm infants: a systematic review.

作者信息

Rios Juliana Ferreira da Silva, Camargos Paulo Augusto Moreira, Corrêa Luísa Petri, Romanelli Roberta Maia de Castro

机构信息

Universidade Federal de Minas Gerais, Santa Efigênia, BH, Brazil.

Universidade Federal de Minas Gerais, Departamento de Pediatria, Santa Efigênia, BH, Brazil.

出版信息

Braz J Infect Dis. 2017 May-Jun;21(3):333-338. doi: 10.1016/j.bjid.2017.01.008. Epub 2017 Mar 10.

DOI:10.1016/j.bjid.2017.01.008
PMID:28286016
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9428001/
Abstract

OBJECTIVE

This article aims to review the use of antifungal prophylaxis with intravenous fluconazole in premature newborns and the occurrence of Invasive Candidiasis.

METHODS

This is a systematic review with search at databases: PubMed, Capes Portal, Virtual Health Library (BVS - Biblioteca Virtual em Saúde)/Lilacs, Scopus and Cochrane. The keywords used were: "Antifungal", "Candida" "Fluconazole prophylaxis" and "Preterm infants".

RESULTS

Invasive Candidiasis was evaluated in all the twelve items. In eleven of them, there was a statistically significant difference between the groups receiving prophylactic fluconazole, with lower frequency of Invasive Candidiasis, compared to placebo or no prophylaxis group. Colonization by Candida species was also evaluated in five studies; four of them presented statistically lower proportion of colonization in patients with Fluconazole prophylaxis, compared to placebo or no drugs. In one study, there was a significant difference, favoring the use of fluconazole, and reduction of death.

CONCLUSION

Studies indicate the effectiveness of prophylaxis with fluconazole, with reduction in the incidence of colonization and invasive fungal disease. The benefits of prophylaxis should be evaluated considering the incidence of candidiasis in the unit, the mortality associated with candidiasis, the safety and toxicity of short and long-term medication, and the potential for development of resistant pathogens.

摘要

目的

本文旨在综述静脉注射氟康唑用于早产儿抗真菌预防的情况以及侵袭性念珠菌病的发生情况。

方法

这是一项系统性综述，检索了以下数据库：PubMed、Capes门户、虚拟健康图书馆（BVS - Biblioteca Virtual em Saúde）/Lilacs、Scopus和Cochrane。使用的关键词为：“抗真菌药”、“念珠菌”、“氟康唑预防”和“早产儿”。

结果

在所有12项研究中均评估了侵袭性念珠菌病。其中11项研究显示，接受氟康唑预防的组与安慰剂组或未预防组相比，侵袭性念珠菌病的发生率在统计学上有显著差异，接受氟康唑预防的组发生率较低。五项研究还评估了念珠菌属的定植情况；其中四项研究表明，与安慰剂组或未用药组相比，接受氟康唑预防的患者定植比例在统计学上较低。在一项研究中，使用氟康唑有显著差异，且降低了死亡率。

结论

研究表明氟康唑预防有效，可降低定植和侵袭性真菌病的发生率。应综合考虑单位内念珠菌病的发生率、与念珠菌病相关的死亡率、短期和长期用药的安全性和毒性以及耐药病原体产生的可能性来评估预防的益处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6897/9428001/4d93589561fe/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6897/9428001/4d93589561fe/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6897/9428001/4d93589561fe/gr1.jpg

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