International Journal
p-ISSN: 2075-4124
e-ISSN: 2075-7107
of Academic Research
National registration No: 2996
CrossRef DOI: 10.7813/2075-4124.2012
Article DOI: 10.7813/2075-4124.2012/4-4/A.10
Hanan Abd-Allah El-Gamal, Sally Mohamed Saber,
Manal Ebrahim El-Hassaneen
Administration of fluconazole as prophylactic systemic antifungal in very low birth weight preterm neonates Abstract: Background: Preterm neonates in neonatal intensive care units (NICUs) are
highly prone to invasive fungal infection (IFI). Candida species is the third most frequent
causal agent of late-onset sepsis (LOS) in preterm neonate very low birth weight. Reducing
fungal colonization may prevent the development of IFI of preterm infants. Therefore it is
necessary to use antifungal prophylaxis with Fluconazole in order to reduce fungal coloniza-
tion and systemic fungal infection in very low birth weight neonates. Objective: To evaluate
the effectiveness of prophylactic systemic Fluconazole in preventive fungal colonization and
invasion in very low birth weight neonates. Methodology: the study was done on one
hundred preterm neonates admitted in NICU Al–Galaa Teaching Hospital during the period
from April 2009 to June 2010. Neonates were subdivided into; Group A: 50 VLBW neonates
received 3mg/kg Fluconazole intravenous for four weeks, every third day for the first 2 weeks
and then every other day during the third and fourth weeks; Group B: 50 VLBW as a control
did not receive Fluconazole. For both groups’ baseline and weekly, throat swab, endotracheal
aspirate, and blood culture were done. For group A liver function tests were done weekly to
assess safety of the drug. Results: The 50 infants randomly assigned to Fluconazole and
the 50 control infants were cross matched in terms of birth weight, gestational age at birth
and base-line risk factors for fungal infection. During the four weeks treatment period, fungal
colonization was detected in 15 infants in control group (30%) and 5 infants in Fluconazole
group (10%) (P value 0.012 significant). Invasive fungal infection (proved with positive fungal
growth in the blood culture); developed in 5 infants (10%) in the control group and none of
infants in Fluconazole group were developed invasive fungal infection (P value 0.022
significant). No adverse effect of Fluconazole therapy was found. Conclusion: Prophylactic
administration of Fluconazole during the first four weeks of life is effective in preventing fungal
colonization and invasive fungal infection in infant with very low birth weight (1001-1500gms).
Keywords: Fluconazole; very low birth weight (VLBW); fungal colonization; invasive fungal
infection (IFI)
Pages: 70-78
Cite this article:
H. Abd-Allah El-Gamal, S.M. Saber, M.E. El-Hassaneen. Administration of fluconazole asprophylactic systemic antifungal in very low birth weight preterm neonates. InternationalJournal of Academic Research Part A; 2012; 4(4), 70-78.


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