Fluconazole prophylaxis is associated with a decreased rate of coagulase-negative Staphylococcal infections in a subset of extremely low birth weight neonates
Fluconazole prophylaxis is being used efficaciously in the neonatal intensive care unit (NICU) for fungal prophylaxis in very low birth weight and extremely low birth weight (ELBW) neonates. Little is known about the effect of fluconazole prophylaxis on bacterial infections. The purpose of this study was to examine that issue in a subset of ELBW, those weighing ≤900 g at birth. This is a retrospective study conducted in a level III NICU at state-designated children hospital in New Jersey (USA). We examined the data from our records of neonates ≤900 g birth weight during the period March 1, 2007–February 28, 2011. Inclusion in the study was all infants ≤900 g before (n = 67) and after (n = 81) the institution of fluconazole prophylaxis. Fluconazole prophylaxis was accompanied by a significant decrease in both the rate and number of days of bacterial infections as well as co-infections. We found that the incidence of coagulase-negative Staphylococcus (CONS) decreased from 46.2 to 24.7 % (OR 2.63; 95 % CI 1.31–5.27). Similarly, days of infection also decreased significantly (p < 0.0001). These data suggest that fluconazole prophylaxis may be associated with a reduction in CONS infections in that subset of ELBW neonates.
KeywordsFluconazole Coagulase negative Staphylococcus Neonatal intensive care unit Extremely low birth weight Neonates Infection rates
We would like to thank Dr. Helen Kest for her support and encouragement during the course of this study. Portions of this work were presented at the Association of Clinical Scientists 132nd meeting, Mobile, AL, 23-27 May, 2012. Abstract: Ann. Clin Lab Sci 2012; 42: 223.
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