title: Update on the management of Candida infections in preterm neonates.
abstract: Invasive fungal infections in preterm neonates in the neonatal intensive care unit are predominantly caused by Candida spp, and have a high burden of morbidity and mortality. Effective prophylactic strategies have recently become available, but the identification of the best possible strategies to manage high-risk infants is still a priority. Choice and use of appropriate antifungal drugs needs careful assessment of neonatal characteristics, the epidemiology and drug pharmacokinetics. Ideally, antifungal drugs for preterm neonates should target fungal bio-films, prevent or effectively treat end-organ localisations, be active against fluconazole-resistant Candida species, and have reliable safety and tolerability profiles. The paper reviews the state-of-the-art in the area of neonatal fungal infections, and addresses some open questions related to the best possible prophylactic and therapeutic strategies to be implemented in such unique patients.
authors.affiliation: Department of Neonatology and NICU, S. Anna Hospital, Torino, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Manzoni
authors.affiliation: Department of Pediatrics, University of Torino, Torino, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Mostert
authors.affiliation: Infectious Disease Unit, Istituto Giannina Gaslini, Genova, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Castagnola
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use*; D018441:Biofilms; D002175:Candida / Q000502:physiology; D002177:Candidiasis / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control; D012307:Risk Factors
chemical_list: D000935:Antifungal Agents
keywords: Candida; Fluconazole; Infectious Diseases; Neonatology; Preterm