Abstract
Invasive candidiasis (IC) is a leading cause of morbidity and mortality in preterm infants. Even if successfully treated, IC can cause significant neurodevelopmental impairment. Preterm infants are at increased risk for hematogenous Candida meningoencephalitis owing to increased permeability of the blood-brain barrier, so antifungal treatment should have adequate central nervous system penetration. Amphotericin B deoxycholate, lipid preparations of amphotericin B, fluconazole, and micafungin are first-line treatments of IC. Fluconazole prophylaxis reduces the incidence of IC in extremely premature infants, but its safety has not been established for this indication, and as yet, the product has not been shown to reduce mortality in neonates. Targeted prophylaxis may have a role in reducing the burden of disease in this vulnerable population.
Copyright © 2012 Elsevier Inc. All rights reserved.
Publication types
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Research Support, N.I.H., Extramural
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Research Support, Non-U.S. Gov't
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Review
MeSH terms
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Antibiotic Prophylaxis / methods*
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Antibiotic Prophylaxis / statistics & numerical data
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Antifungal Agents* / classification
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Antifungal Agents* / therapeutic use
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Blood-Brain Barrier / drug effects
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Blood-Brain Barrier / physiopathology
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Candida* / drug effects
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Candida* / isolation & purification
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Candida* / pathogenicity
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Candidiasis, Invasive* / drug therapy
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Candidiasis, Invasive* / microbiology
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Candidiasis, Invasive* / mortality
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Candidiasis, Invasive* / physiopathology
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Catheter-Related Infections / drug therapy
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Catheter-Related Infections / microbiology
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Catheter-Related Infections / mortality
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Catheter-Related Infections / physiopathology
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Central Nervous System / growth & development
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Child Development
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Cross Infection / drug therapy
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Cross Infection / microbiology
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Cross Infection / mortality
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Cross Infection / physiopathology
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Humans
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Incidence
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Infant, Newborn
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Infant, Premature
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Infant, Premature, Diseases* / drug therapy
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Infant, Premature, Diseases* / microbiology
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Infant, Premature, Diseases* / mortality
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Infant, Premature, Diseases* / physiopathology
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Meningoencephalitis* / drug therapy
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Meningoencephalitis* / microbiology
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Meningoencephalitis* / mortality
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Meningoencephalitis* / physiopathology
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Randomized Controlled Trials as Topic