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Fluconazole prophylaxis against invasive candidiasis in very low and extremely low birth weight preterm neonates: a systematic review and meta-analysis

Clinical and Experimental Pediatrics 2021년 64권 4호 p.172 ~ 179
Anaraki Mahmoud Robati, Nouri-Vaskeh Masoud, Oskoei Shahram Abdoli,
소속 상세정보
 ( Anaraki Mahmoud Robati ) - Tabriz University of Medical Sciences Dental and Periodontal Research Center
 ( Nouri-Vaskeh Masoud ) - Tabriz University of Medical Sciences Immunology Research Center
 ( Oskoei Shahram Abdoli ) - Tabriz University of Medical Sciences Pediatric Health Research Center

Abstract


Background: Evidence shows that fluconazole prophylaxis is an effective treatment against invasive fungal infections in preterm neonates, however, the most efficient schedule of fluconazole prophylaxis for the colonization and mortality of invasive candidiasis (IC) is unknown.

Purpose: This systematic review and meta-analysis aimed to assess the efficiency of different prophylactic fluconazole schedules in controlling IC colonization, infection, and mortality in very low birth weight (VLBW) and extremely low birth weight (ELBW) infants in neonatal intensive care units.

Methods: We searched the PubMed, Scopus, Embase, and Cochrane databases using the keywords “candida,” “invasive candidiasis,” “IC,” “fluconazole prophylaxis,” “preterm infants,” “very low birth weight infants,” “VLBW,” “extremely low birth weight,” and “ELBW.”

Results: Mortality was significantly decreased in a meta-analysis of studies using different fluconazole prophylaxis regimens. The meta-analysis also indicated a significant decrease in the incidence of IC-associated mortality in ELBW infants using the same fluconazole prophylaxis schedules.

Conclusion: Future studies should explore the effectiveness of other different fluconazole prophylaxis schedules on IC colonization, infection, and mortality.

키워드

Preterm infants; Very low birth weight; Extremely low birth weight; Fluconazole; Invasive candidiasis

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