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Fluconazole prophylaxis for prevention of invasive candidiasis in infants

Ericson, Jessica E.a , b; Benjamin, Daniel K. Jra , b

Current Opinion in Pediatrics: April 2014 - Volume 26 - Issue 2 - p 151–156
doi: 10.1097/MOP.0000000000000060
NEONATOLOGY AND PERINATOLOGY: Edited by Richard A. Polin and Tara M. Randis

Purpose of review Invasive candidiasis is a serious infection in hospitalized infants that results in significant mortality and morbidity. Fluconazole is approved by the US Food and Drug Administration for prophylaxis of invasive candidiasis in patients undergoing bone marrow transplantation but is not approved for use in infants. This review will describe the history of fluconazole use for prophylaxis in infants.

Recent findings Limiting fluconazole prophylaxis to infants with risk factors, in addition to low birth weight and early gestational age, reduces the number of infants treated with fluconazole and the duration of fluconazole therapy for each infant.

Summary Fluconazole prophylaxis appears to be well tolerated for use in premature infants. Reduction in the incidence of invasive candidiasis is observed even when prophylaxis is limited to infants with multiple risk factors. Centers with a low incidence of invasive candidiasis may not benefit from fluconazole prophylaxis. Significant short-term and long-term toxicity and increases in fluconazole-resistant organisms have not been observed with fluconazole use in the intensive care nursery.

aDuke Clinical Research Institute

bDepartment of Pediatrics, Duke University, Durham, North Carolina, USA

Correspondence to Daniel K. Benjamin Jr., MD, PhD, MPH, Professor, Duke University, Pediatrics, Duke Clinical Research Institute, P.O. Box 17969, Durham, NC 27715, USA. Tel: +1 919 668 8295; e-mail:

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins