title: Impact of 'targeted' fluconazole prophylaxis for preterm neonates: efficacy of a highly selective approach?
abstract: OBJECTIVE
  The objective of this study was to evaluate the efficacy of targeted intermittent fluconazole prophylaxis (FP) to high-risk preterm (PT) infants.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Division of Neonatology, Department of Pediatrics, Wayne State University, Detroit, MI, USA.
authors.forename: A
authors.initials: A
authors.lastname: Martin
authors.forename: A
authors.initials: A
authors.lastname: Pappas
authors.forename: M
authors.initials: M
authors.lastname: Lulic-Botica
authors.forename: G
authors.initials: G
authors.lastname: Natarajan
mesh_terms: D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D000935:Antifungal Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D058365:Candidiasis, Invasive / Q000188:drug therapy / Q000517:prevention & control*; D005260:Female; D015725:Fluconazole / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000188:drug therapy / Q000517:prevention & control*; D019370:Observation; D012307:Risk Factors
chemical_list: D000900:Anti-Bacterial Agents; D000935:Antifungal Agents; D015725:Fluconazole