Skip Navigation LinksHome > August 2008 - Volume 27 - Issue 8 > Routine Use of Fluconazole Prophylaxis in a Neonatal Intensi...
Pediatric Infectious Disease Journal:
doi: 10.1097/INF.0b013e318170bb0c
Original Studies

Routine Use of Fluconazole Prophylaxis in a Neonatal Intensive Care Unit Does Not Select Natively Fluconazole-Resistant Candida Subspecies

Manzoni, Paolo MD*; Leonessa, MariaLisa MD*; Galletto, Paolo MD*; Latino, Maria Agnese MD†; Arisio, Riccardo MD‡; Maule, Milena MD§; Agriesti, Giovanni MD*; Gastaldo, Luca MD*; Gallo, Elena MD*; Mostert, Michael MD¶; Farina, Daniele MD*

Collapse Box


Background: We have previously demonstrated efficacy against fungal colonization and infection of fluconazole prophylaxis that was routinely administered since 2001 in our ICU for preterm infants <1500 g at birth (VLBW). With prolonged use, concerns exist for the emergence of acquired fungal resistance and of Candida subspecies that are natively fluconazole-resistant (NFR), mostly Candida glabrata and Candida krusei.

Methods: We evaluated retrospectively all clinical and surveillance fungal isolates obtained from VLBW infants in our NICU during a 10-year period (1997–2006). Each fungal isolate was speciated, infants colonized or infected with NFR-Candida spp were identified and the incidence rates of colonization and infection by these fungal species were calculated. A comparison was made of the 6-year (2001–2006) prophylaxis period with the 4-year (1997–2000) preprophylaxis period.

Results: Overall, colonization by NFR-Candida spp ranged between 2.8% and 6.6% of VLBW infants yearly admitted, without any increasing trend during the study period. There were 18 of 434 (4.1%) neonates colonized by these species. Five episodes of systemic fungal infections caused by NFR-Candida spp occurred (incidence rate, 1.1%). No significant differences were detected when compared with the preprophylaxis period, when 11 of 295 infants (3.7%) were colonized by NFR-Candida spp and 4 episodes of infection occurred (1.4%) (P = 0.84 and 0.76, respectively).

Conclusions: Fluconazole prophylaxis administered to VLBW neonates in 4- to 6-week courses after birth does not lead to the emergence of natively fluconazole-resistant Candida spp.

© 2008 Lippincott Williams & Wilkins, Inc.


Article Tools


Article Level Metrics

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.