title: Prophylactic fluconazole in very low birth weight infants admitted to neonatal intensive care unit: randomized controlled trial.
abstract: OBJECTIVE
  To evaluate the effect of fluconazole prophylaxis on invasive fungal infection (IFI) in very low birth weight (VLBW) infants in the Neonatal Intensive Care Unit (NICU).
  
  
  METHODS
  VLBW infants receiving antibiotics for more than 3 days were randomized to receive either fluconazole (6 mg/kg) or placebo, every other day for 7 days followed by everyday till day 28 or discharge whichever was earlier. The primary outcome was IFI, and secondary outcome was fungal attributable mortality and all-cause mortality.
  
  
  RESULTS
  The incidence of IFI was significantly lower (21%) in the fluconazole group compared to the control group (43.2%, 95%CI 0.09-0.37, p < 0.05). The ARR (absolute risk reduction) was 22.2% and the NNT (number needed to treat) was 5. Fungal attributable mortality was also lower in the fluconazole group (2.6% versus 18.9%, 95%CI 0.003-0.52, p < 0.05).
  
  
  CONCLUSIONS
  In VLBW neonates on the NICU, use of fluconazole prophylaxis decreases IFI and fungal attributable mortality.
authors.affiliation: a Department of Paediatrics .
authors.forename: Harita
authors.initials: H
authors.lastname: Kirpal
authors.affiliation: a Department of Paediatrics .
authors.forename: Geeta
authors.initials: G
authors.lastname: Gathwala
authors.affiliation: b Department of Microbiology , Pt. B.D. Sharma PGIMS , Rohtak , Haryana , India , and.
authors.forename: Uma
authors.initials: U
authors.lastname: Chaudhary
authors.affiliation: c Department of Neonatology , Fernandez Hospital , Hyderguda , Hyderabad , Andhra Pradesh , India.
authors.forename: Deepak
authors.initials: D
authors.lastname: Sharma
mesh_terms: D000935:Antifungal Agents / Q000627:therapeutic use*; D002177:Candidiasis / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D015725:Fluconazole / Q000627:therapeutic use*; D006801:Humans; D007194:India / Q000453:epidemiology; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000382:microbiology / Q000517:prevention & control; D019102:Infant, Very Low Birth Weight; D007363:Intensive Care Units, Neonatal; D008297:Male; D018805:Sepsis / Q000382:microbiology / Q000517:prevention & control*
chemical_list: D000935:Antifungal Agents; D015725:Fluconazole
keywords: Fungal sepsis; VLBW infants; prophylactic fluconazole