title: Fluconazole prophylaxis in preterm infants: a systematic review.
abstract: OBJECTIVE
  This article aims to review the use of antifungal prophylaxis with intravenous fluconazole in premature newborns and the occurrence of Invasive Candidiasis.
  
  
  METHODS
  This is a systematic review with search at databases: PubMed, Capes Portal, Virtual Health Library (BVS - Biblioteca Virtual em Saúde)/Lilacs, Scopus and Cochrane. The keywords used were: "Antifungal", "Candida" "Fluconazole prophylaxis" and "Preterm infants".
  
  
  RESULTS
  Invasive Candidiasis was evaluated in all the twelve items. In eleven of them, there was a statistically significant difference between the groups receiving prophylactic fluconazole, with lower frequency of Invasive Candidiasis, compared to placebo or no prophylaxis group. Colonization by Candida species was also evaluated in five studies; four of them presented statistically lower proportion of colonization in patients with Fluconazole prophylaxis, compared to placebo or no drugs. In one study, there was a significant difference, favoring the use of fluconazole, and reduction of death.
  
  
  CONCLUSIONS
  Studies indicate the effectiveness of prophylaxis with fluconazole, with reduction in the incidence of colonization and invasive fungal disease. The benefits of prophylaxis should be evaluated considering the incidence of candidiasis in the unit, the mortality associated with candidiasis, the safety and toxicity of short and long-term medication, and the potential for development of resistant pathogens.
authors.affiliation: Universidade Federal de Minas Gerais, Santa Efigênia, BH, Brazil. Electronic address: juriosalvim@yahoo.com.br.
authors.forename: Juliana Ferreira da Silva
authors.initials: JFDS
authors.lastname: Rios
authors.affiliation: Universidade Federal de Minas Gerais, Departamento de Pediatria, Santa Efigênia, BH, Brazil.
authors.forename: Paulo Augusto Moreira
authors.initials: PAM
authors.lastname: Camargos
authors.affiliation: Universidade Federal de Minas Gerais, Santa Efigênia, BH, Brazil.
authors.forename: Luísa Petri
authors.initials: LP
authors.lastname: Corrêa
authors.affiliation: Universidade Federal de Minas Gerais, Departamento de Pediatria, Santa Efigênia, BH, Brazil.
authors.forename: Roberta Maia de Castro
authors.initials: RMC
authors.lastname: Romanelli
mesh_terms: D000935:Antifungal Agents / Q000008:administration & dosage*; D058365:Candidiasis, Invasive / Q000517:prevention & control*; D015725:Fluconazole / Q000008:administration & dosage*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000517:prevention & control*
chemical_list: D000935:Antifungal Agents; D015725:Fluconazole
keywords: Antifungal; Candida; Fluconazole prophylaxis; Preterm infants