title: Fluconazole prophylaxis in extremely low birth weight infants and neurodevelopmental outcomes and quality of life at 8 to 10 years of age.
abstract: OBJECTIVE
  To examine the long-term effects of fluconazole prophylaxis in extremely low birth weight infants.
  
  
  METHODS
  Neurodevelopmental status and quality of life of survivors from a randomized, placebo-controlled trial of fluconazole prophylaxis were evaluated at 8 to 10 years of life using the Vineland Adaptive Behavior Scales-II (VABS-II) and the Child Health Questionnaire Parent-Completed Form 28 (CHQ-PF28), respectively.
  
  
  RESULTS
  VABS-II Domain Scores for the fluconazole-treated (n = 21; 9.1 ± 0.7 years) compared with the placebo group (n = 17; 9.3 ± 0.8 years) were similar for communication [94.6 (±14.8) versus 92.6 (±12.6), P = .65], daily living skills [87.9 (±10.6) versus 87.4 (±9.3), P = .89], socialization [97.2 (±9.2) versus 94.4 (±7.9), P = .31], and motor skills [92.1 (±17.8) versus 95.1 (±14.6), P = .57]. Internalizing and externalizing behaviors and maladaptive behavior index were also similar. The CHQ-PF28 revealed no differences between the two groups regarding quality of life. Survivors were also happy or satisfied with school (90% versus 100%, P = .49), friendships (90% versus 88%, P = 1.00), and life (95% versus 100%, P = 1.00). Self esteem scores were 87.3 ± 15.7 versus 89.7 ± 10.4 (P = .59). There were also no differences between groups regarding emotional difficulties or behavior problems.
  
  
  CONCLUSIONS
  Fluconazole prophylaxis for the prevention of invasive Candida infections is safe in extremely low birth weight infants and does not appear to be associated with any long-term adverse effects on neurodevelopment and quality of life at 8 to 10 years of life.
authors.affiliation: Pediatrics, University of Virginia School of Medicine, Charlottesville, VA 22908, USA. dak4r@virginia.edu
authors.forename: David A
authors.initials: DA
authors.lastname: Kaufman
authors.forename: Amy L
authors.initials: AL
authors.lastname: Cuff
authors.forename: Julia B
authors.initials: JB
authors.lastname: Wamstad
authors.forename: Robert
authors.initials: R
authors.lastname: Boyle
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Gurka
authors.forename: Leigh B
authors.initials: LB
authors.lastname: Grossman
authors.forename: Peter
authors.initials: P
authors.lastname: Patrick
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use; D002177:Candidiasis / Q000517:prevention & control; D002648:Child; D002658:Developmental Disabilities / Q000517:prevention & control*; D004311:Double-Blind Method; D005260:Female; D015725:Fluconazole / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D008297:Male; D011446:Prospective Studies; D011788:Quality of Life; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000935:Antifungal Agents; D015725:Fluconazole