Twice-weekly fluconazole prophylaxis in premature infants: Association with cholestasis
Background: Fluconazole prophylaxis is effective in preventing invasive candidiasis in extremely low‐birthweight (ELBW) infants. The authors previously reported an increased incidence of cholestasis with fluconazole prophylaxis in ELBW infants, which led to fluconazole prophylaxis being changed to...
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Veröffentlicht in: | Pediatrics international 2011-08, Vol.53 (4), p.475-479 |
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description | Background: Fluconazole prophylaxis is effective in preventing invasive candidiasis in extremely low‐birthweight (ELBW) infants. The authors previously reported an increased incidence of cholestasis with fluconazole prophylaxis in ELBW infants, which led to fluconazole prophylaxis being changed to a less frequent dosing (LFD) schedule of twice a week at their institution. The purpose of the present study was therefore to evaluate the effectiveness and safety of LFD fluconazole prophylaxis in preventing invasive candidiasis in ELBW infants.
Methods: ELBW infants who received the LFD regimen of fluconazole (twice a week for up to 6 weeks) were compared with infants who received the frequent dosing (FD) schedule (every 72 h for first 2 weeks, every 48 h for next 2 weeks and every 24 h for the final 2 weeks). The two groups were compared for baseline demographics, risk factors for candidiasis, the rate of invasive fungal infection and the incidence and severity of cholestasis.
Results: There was no significant difference in the incidence of invasive candidiasis in infants who received the LFD (2/104, 2%) compared to FD (0/140, 0%; P= 0.4) fluconazole prophylaxis. The severity of cholestasis was lower and a trend towards decreased incidence of cholestasis was observed on the LFD schedule.
Conclusion: The LFD regimen of fluconazole prophylaxis is effective in preventing invasive fungal infection in ELBW infants. The severity of cholestasis was decreased with the LFD schedule. |
doi_str_mv | 10.1111/j.1442-200X.2010.03286.x |
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Methods: ELBW infants who received the LFD regimen of fluconazole (twice a week for up to 6 weeks) were compared with infants who received the frequent dosing (FD) schedule (every 72 h for first 2 weeks, every 48 h for next 2 weeks and every 24 h for the final 2 weeks). The two groups were compared for baseline demographics, risk factors for candidiasis, the rate of invasive fungal infection and the incidence and severity of cholestasis.
Results: There was no significant difference in the incidence of invasive candidiasis in infants who received the LFD (2/104, 2%) compared to FD (0/140, 0%; P= 0.4) fluconazole prophylaxis. The severity of cholestasis was lower and a trend towards decreased incidence of cholestasis was observed on the LFD schedule.
Conclusion: The LFD regimen of fluconazole prophylaxis is effective in preventing invasive fungal infection in ELBW infants. The severity of cholestasis was decreased with the LFD schedule.</description><identifier>ISSN: 1328-8067</identifier><identifier>EISSN: 1442-200X</identifier><identifier>DOI: 10.1111/j.1442-200X.2010.03286.x</identifier><identifier>PMID: 21040197</identifier><language>eng</language><publisher>Melbourne, Australia: Blackwell Publishing Asia</publisher><subject>Antifungal Agents - administration & dosage ; Antifungal Agents - adverse effects ; Antifungal Agents - therapeutic use ; Candidiasis, Invasive - epidemiology ; Candidiasis, Invasive - prevention & control ; Cholestasis - chemically induced ; Cholestasis - epidemiology ; conjugated hyperbilirubinemia ; demography ; Drug Administration Schedule ; Drug dosages ; Female ; Fluconazole - administration & dosage ; Fluconazole - adverse effects ; Fluconazole - therapeutic use ; fungal infection ; Fungal infections ; Humans ; Incidence ; Infant, Extremely Low Birth Weight ; Infant, Newborn ; Infant, Premature ; Infant, Premature, Diseases - prevention & control ; Infants ; infection ; Linear Models ; Male ; Premature birth ; preterm infants ; Preventive medicine ; Retrospective Studies ; Risk Factors</subject><ispartof>Pediatrics international, 2011-08, Vol.53 (4), p.475-479</ispartof><rights>2011 The Authors. Pediatrics International © 2011 Japan Pediatric Society</rights><rights>2011 The Authors. Pediatrics International © 2011 Japan Pediatric Society.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5186-680ca0c640db2f017976a24560ba19af9d5f61e894c1912880ccca419c1433323</citedby><cites>FETCH-LOGICAL-c5186-680ca0c640db2f017976a24560ba19af9d5f61e894c1912880ccca419c1433323</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1442-200X.2010.03286.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1442-200X.2010.03286.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21040197$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bhat, Vishwanath</creatorcontrib><creatorcontrib>Fojas, Milliecor</creatorcontrib><creatorcontrib>Saslow, Judy G.</creatorcontrib><creatorcontrib>Shah, Sahil</creatorcontrib><creatorcontrib>Sannoh, Sulaiman</creatorcontrib><creatorcontrib>Amendolia, Barbara</creatorcontrib><creatorcontrib>Pyon, Kee</creatorcontrib><creatorcontrib>Kemble, Nicole</creatorcontrib><creatorcontrib>Stahl, Gary</creatorcontrib><creatorcontrib>Aghai, Zubair H.</creatorcontrib><title>Twice-weekly fluconazole prophylaxis in premature infants: Association with cholestasis</title><title>Pediatrics international</title><addtitle>Pediatr Int</addtitle><description>Background: Fluconazole prophylaxis is effective in preventing invasive candidiasis in extremely low‐birthweight (ELBW) infants. The authors previously reported an increased incidence of cholestasis with fluconazole prophylaxis in ELBW infants, which led to fluconazole prophylaxis being changed to a less frequent dosing (LFD) schedule of twice a week at their institution. The purpose of the present study was therefore to evaluate the effectiveness and safety of LFD fluconazole prophylaxis in preventing invasive candidiasis in ELBW infants.
Methods: ELBW infants who received the LFD regimen of fluconazole (twice a week for up to 6 weeks) were compared with infants who received the frequent dosing (FD) schedule (every 72 h for first 2 weeks, every 48 h for next 2 weeks and every 24 h for the final 2 weeks). The two groups were compared for baseline demographics, risk factors for candidiasis, the rate of invasive fungal infection and the incidence and severity of cholestasis.
Results: There was no significant difference in the incidence of invasive candidiasis in infants who received the LFD (2/104, 2%) compared to FD (0/140, 0%; P= 0.4) fluconazole prophylaxis. The severity of cholestasis was lower and a trend towards decreased incidence of cholestasis was observed on the LFD schedule.
Conclusion: The LFD regimen of fluconazole prophylaxis is effective in preventing invasive fungal infection in ELBW infants. The severity of cholestasis was decreased with the LFD schedule.</description><subject>Antifungal Agents - administration & dosage</subject><subject>Antifungal Agents - adverse effects</subject><subject>Antifungal Agents - therapeutic use</subject><subject>Candidiasis, Invasive - epidemiology</subject><subject>Candidiasis, Invasive - prevention & control</subject><subject>Cholestasis - chemically induced</subject><subject>Cholestasis - epidemiology</subject><subject>conjugated hyperbilirubinemia</subject><subject>demography</subject><subject>Drug Administration Schedule</subject><subject>Drug dosages</subject><subject>Female</subject><subject>Fluconazole - administration & dosage</subject><subject>Fluconazole - adverse effects</subject><subject>Fluconazole - therapeutic use</subject><subject>fungal infection</subject><subject>Fungal infections</subject><subject>Humans</subject><subject>Incidence</subject><subject>Infant, Extremely Low Birth Weight</subject><subject>Infant, Newborn</subject><subject>Infant, Premature</subject><subject>Infant, Premature, Diseases - prevention & control</subject><subject>Infants</subject><subject>infection</subject><subject>Linear Models</subject><subject>Male</subject><subject>Premature birth</subject><subject>preterm infants</subject><subject>Preventive medicine</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><issn>1328-8067</issn><issn>1442-200X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkctu2zAQRYmiRfPqLxRCNl3JGT5EkQGySOzUKWC0WSRwdgRNUzAdWXJECbbz9R3VqRfdpFyQM8Nzh49LSEJhQHFcLAdUCJYygKcBA6wCZ0oOth_I8WHjI8ZYTRXI_IicxLgEAJUr8ZkcMQoCqM6PyfRhE5xPN94_l7ukKDtXV_a1Ln2ybur1YlfabYhJqDD1K9t2jceksFUbL5PrGGsXbBvqKtmEdpG4BQpja2OIZ-RTYcvov7ytp-Tx--3D8C6d_Br_GF5PUpdRJVOpwFlwUsB8xgqguc6lZSKTMLNU20LPs0JSr7RwVFOmEHfOCqodFZxzxk_Jt31fvO5Lh4ebVYjOl6WtfN1Fo_G7Mq40fZdUCn8u51mG5Pk_5LLumgqf0UNMa5wRUnvINXWMjS_Mugkr2-wMBdObZJam98L0XpjeJPPHJLNF6de3_t1s5ecH4V9XELjaA5tQ-t1_Nzb3t6M-Qn2614fY-u1Bb5tnI3OeZ2b6c2zGUxiNbiZgRvw33nyu3A</recordid><startdate>201108</startdate><enddate>201108</enddate><creator>Bhat, Vishwanath</creator><creator>Fojas, Milliecor</creator><creator>Saslow, Judy G.</creator><creator>Shah, Sahil</creator><creator>Sannoh, Sulaiman</creator><creator>Amendolia, Barbara</creator><creator>Pyon, Kee</creator><creator>Kemble, Nicole</creator><creator>Stahl, Gary</creator><creator>Aghai, Zubair H.</creator><general>Blackwell Publishing Asia</general><general>Blackwell Publishing Ltd</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><scope>7U1</scope><scope>7U2</scope><scope>C1K</scope></search><sort><creationdate>201108</creationdate><title>Twice-weekly fluconazole prophylaxis in premature infants: Association with cholestasis</title><author>Bhat, Vishwanath ; Fojas, Milliecor ; Saslow, Judy G. ; Shah, Sahil ; Sannoh, Sulaiman ; Amendolia, Barbara ; Pyon, Kee ; Kemble, Nicole ; Stahl, Gary ; Aghai, Zubair H.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5186-680ca0c640db2f017976a24560ba19af9d5f61e894c1912880ccca419c1433323</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Antifungal Agents - administration & dosage</topic><topic>Antifungal Agents - adverse effects</topic><topic>Antifungal Agents - therapeutic use</topic><topic>Candidiasis, Invasive - epidemiology</topic><topic>Candidiasis, Invasive - prevention & control</topic><topic>Cholestasis - chemically induced</topic><topic>Cholestasis - epidemiology</topic><topic>conjugated hyperbilirubinemia</topic><topic>demography</topic><topic>Drug Administration Schedule</topic><topic>Drug dosages</topic><topic>Female</topic><topic>Fluconazole - administration & dosage</topic><topic>Fluconazole - adverse effects</topic><topic>Fluconazole - therapeutic use</topic><topic>fungal infection</topic><topic>Fungal infections</topic><topic>Humans</topic><topic>Incidence</topic><topic>Infant, Extremely Low Birth Weight</topic><topic>Infant, Newborn</topic><topic>Infant, Premature</topic><topic>Infant, Premature, Diseases - prevention & control</topic><topic>Infants</topic><topic>infection</topic><topic>Linear Models</topic><topic>Male</topic><topic>Premature birth</topic><topic>preterm infants</topic><topic>Preventive medicine</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bhat, Vishwanath</creatorcontrib><creatorcontrib>Fojas, Milliecor</creatorcontrib><creatorcontrib>Saslow, Judy G.</creatorcontrib><creatorcontrib>Shah, Sahil</creatorcontrib><creatorcontrib>Sannoh, Sulaiman</creatorcontrib><creatorcontrib>Amendolia, Barbara</creatorcontrib><creatorcontrib>Pyon, Kee</creatorcontrib><creatorcontrib>Kemble, Nicole</creatorcontrib><creatorcontrib>Stahl, Gary</creatorcontrib><creatorcontrib>Aghai, Zubair H.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>Risk Abstracts</collection><collection>Safety Science and Risk</collection><collection>Environmental Sciences and Pollution Management</collection><jtitle>Pediatrics international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bhat, Vishwanath</au><au>Fojas, Milliecor</au><au>Saslow, Judy G.</au><au>Shah, Sahil</au><au>Sannoh, Sulaiman</au><au>Amendolia, Barbara</au><au>Pyon, Kee</au><au>Kemble, Nicole</au><au>Stahl, Gary</au><au>Aghai, Zubair H.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Twice-weekly fluconazole prophylaxis in premature infants: Association with cholestasis</atitle><jtitle>Pediatrics international</jtitle><addtitle>Pediatr Int</addtitle><date>2011-08</date><risdate>2011</risdate><volume>53</volume><issue>4</issue><spage>475</spage><epage>479</epage><pages>475-479</pages><issn>1328-8067</issn><eissn>1442-200X</eissn><abstract>Background: Fluconazole prophylaxis is effective in preventing invasive candidiasis in extremely low‐birthweight (ELBW) infants. The authors previously reported an increased incidence of cholestasis with fluconazole prophylaxis in ELBW infants, which led to fluconazole prophylaxis being changed to a less frequent dosing (LFD) schedule of twice a week at their institution. The purpose of the present study was therefore to evaluate the effectiveness and safety of LFD fluconazole prophylaxis in preventing invasive candidiasis in ELBW infants.
Methods: ELBW infants who received the LFD regimen of fluconazole (twice a week for up to 6 weeks) were compared with infants who received the frequent dosing (FD) schedule (every 72 h for first 2 weeks, every 48 h for next 2 weeks and every 24 h for the final 2 weeks). The two groups were compared for baseline demographics, risk factors for candidiasis, the rate of invasive fungal infection and the incidence and severity of cholestasis.
Results: There was no significant difference in the incidence of invasive candidiasis in infants who received the LFD (2/104, 2%) compared to FD (0/140, 0%; P= 0.4) fluconazole prophylaxis. The severity of cholestasis was lower and a trend towards decreased incidence of cholestasis was observed on the LFD schedule.
Conclusion: The LFD regimen of fluconazole prophylaxis is effective in preventing invasive fungal infection in ELBW infants. The severity of cholestasis was decreased with the LFD schedule.</abstract><cop>Melbourne, Australia</cop><pub>Blackwell Publishing Asia</pub><pmid>21040197</pmid><doi>10.1111/j.1442-200X.2010.03286.x</doi><tpages>5</tpages></addata></record> |
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subjects | Antifungal Agents - administration & dosage Antifungal Agents - adverse effects Antifungal Agents - therapeutic use Candidiasis, Invasive - epidemiology Candidiasis, Invasive - prevention & control Cholestasis - chemically induced Cholestasis - epidemiology conjugated hyperbilirubinemia demography Drug Administration Schedule Drug dosages Female Fluconazole - administration & dosage Fluconazole - adverse effects Fluconazole - therapeutic use fungal infection Fungal infections Humans Incidence Infant, Extremely Low Birth Weight Infant, Newborn Infant, Premature Infant, Premature, Diseases - prevention & control Infants infection Linear Models Male Premature birth preterm infants Preventive medicine Retrospective Studies Risk Factors |
title | Twice-weekly fluconazole prophylaxis in premature infants: Association with cholestasis |
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