Observational studyBMC pediatrics2016
Efficacy and safety of fluconazole prophylaxis in extremely low birth weight infants: multicenter pre-post cohort study.
Observational study in BMC pediatrics, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it, 32 citations in OpenAlex.
- Neonatal Fungemia by Non-Candida Rare Opportunistic Yeasts: A Systematic Review of Literature.International journal of molecular sciences · 2024Pooled it
- Population Pharmacokinetic Study of Prophylactic Fluconazole in Preterm Infants for Prevention of Invasive Candidiasis.Antimicrobial agents and chemotherapy · 2019Trial
- Effect of fluconazole prophylaxis on Candida fluconazole susceptibility in premature infants.The Journal of antimicrobial chemotherapy · 2018Trial
- Pharmacokinetics and safety of fluconazole and micafungin in neonates with systemic candidiasis: a randomized, open-label clinical trial.British journal of clinical pharmacology · 2018Trial
- [Efficacy of fluconazole prophylaxis for late-onset invasive fungal infection in very preterm infants/very low birth weight infants: a retrospective cohort study based on propensity score matching].Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2026Article
- Clinical characteristics of invasive candidiasis in infants born before 30 weeks of gestation: a nested case series from a multicenter cohort study in the Netherlands and Belgium.European journal of pediatrics · 2026Article
- Irrational and Inappropriate Use of Antifungals in the NICU: A Narrative Review.Antibiotics (Basel, Switzerland) · 2026Review
- Invasive Candida Infections in Neonatal Intensive Care Units: Risk Factors and New Insights in Prevention.Pathogens (Basel, Switzerland) · 2024Review
- Incidence of Antimicrobial-Associated Acute Kidney Injury in Children: A Structured Review.Paediatric drugs · 2024Review
- Candida parapsilosis complex in the clinical setting.Nature reviews. Microbiology · 2024Review
- Prophylactic fluconazole protocol in very low birth weight infants: invasive candidiasis prevention in a Latin American neonatal intensive care unit.Journal of perinatology : official journal of the California Perinatal Association · 2023Article
- Article
- Prophylaxis of Invasive Fungal Infection in Neonates: A Narrative Review for Practical Purposes.Journal of fungi (Basel, Switzerland) · 2023Article
- Characteristics of Biofilms Formed byJournal of fungi (Basel, Switzerland) · 2022Article
- Updates in the Pharmacologic Prophylaxis and Treatment of Invasive Candidiasis in the Pediatric and Neonatal Intensive Care Units: Updates in the Pharmacologic Prophylaxis.Current treatment options in infectious diseases · 2022Article
- Clinical and Microbiological Characteristics of Neonates with Candidemia and Impacts of Therapeutic Strategies on the Outcomes.Journal of fungi (Basel, Switzerland) · 2022Article
- 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 · 2021Article
- Prophylactic Use of Fluconazole in Very Premature Infants.Frontiers in pediatrics · 2021Article
- Review of Fluconazole Treatment and Prophylaxis for Invasive Candidiasis in Neonates.The journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG · 2021Review
- Etiology and Outcome of Candidemia in Neonates and Children in Europe: An 11-year Multinational Retrospective Study.The Pediatric infectious disease journal · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThere have been many studies supporting fluconazole prophylaxis in preterm infants for prevention of invasive fungal infections (IFIs). However, the routine use of fluconazole prophylaxis in neonatal intensive care units (NICUs) raises concerns with respect to resistance development, including the selection of resistant Candida species. We aimed to evaluate the efficacy and safety of fluconazole prophylaxis in extremely low birth weight (ELBW) infants.
methodsAn interventional pre-post cohort study at two tertiary NICUs was conducted. Data from two 5-year periods with and without fluconazole prophylaxis (Mar 2008-Feb 2013 and Mar 2003-Feb 2008) was compared. Prophylactic fluconazole was administered starting on the 3rd day at a dose of 3 mg/kg twice a week for 4 weeks during the prophylaxis period.
resultsThe fluconazole prophylaxis group consisted of 264 infants, and the non-prophylaxis group consisted of 159 infants. IFI occurred in a total of 19 neonates (4.7 %) during the 10-year study period. Fluconazole prophylaxis lower the fungal colonization rate significantly (59.1 % vs. 33.9 %, P <0.001). However, the incidence of IFIs in ELBW infants was not reduced after fluconazole prophylaxis (4.4 % vs. 5.5 %, P = 0.80). Rather, although the increase did not reach statistical significance, fluconazole prophylaxis tended to increase the incidence of invasive infections involving fluconazole-resistant C. parapsilosis (0 % vs. 41.7 %, P = 0.11).
conclusionsFluconazole prophylaxis was not efficacious in decreasing IFIs in ELBW infants. There is a need for targeting prophylaxis to greatest risk population and prospective studies to measure the long-term effect of fluconazole prophylaxis on the emergence of organisms with antifungal resistance.
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Registered trials
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