Neonatal fungal infections: when to treat?
Candida infections are a major cause of morbidity and mortality in neonatal intensive care units. Mortality following Candida bloodstream infections is as high as 40%, and neurodevelopmental impairment is common among survivors. Because invasive fungal infections are common and extremely difficult to diagnose, empirical treatment with antifungal therapy should be considered in high-risk, low-birth-weight infants who fail to quickly respond to empirical antibacterial treatment. Risk factors to consider when deciding to administer empirical antifungal therapy include: prior exposure to third-generation cephalosporins, extreme prematurity, and presence of central venous catheters.
Duke-National University of Singapore Graduate Medical School, Singapore.
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E
Hsieh
P B
PB
Smith
E
E
Jacqz-Aigrain
F
F
Kaguelidou
M
M
Cohen-Wolkowiez
P
P
Manzoni
D K
DK
Benjamin
D000935:Antifungal Agents / Q000627:therapeutic use*; D058365:Candidiasis, Invasive / Q000188:drug therapy*; D002494:Central Nervous System Infections / Q000188:drug therapy; D062905:Central Venous Catheters; D002511:Cephalosporins / Q000627:therapeutic use*; D016469:Fungemia / Q000188:drug therapy; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000188:drug therapy*; D012307:Risk Factors; D016896:Treatment Outcome
D000935:Antifungal Agents; D002511:Cephalosporins