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題名 Effects of Fluconazole Prophylaxis Against Systemic Fungal Infection in Extremely-low-birth-weight Infants
其他題名 投予預防性Fluconazole對降低極低體重兒全身性黴菌感染成效評估
作者 Tsai,Cheng-Hsien ;Cheng,Ching-Lan ;Lin,Yuh-Jyh ;Liu,Ching-Chuan ;Kao,Yea-Huei ;Lin,Chyi-Her
蔡政憲;鄭靜蘭;林毓志;劉清泉;高雅慧;林其和
貢獻者 風管系
關鍵詞 Fluconazole ;chemoprophylaxis ; extremely-low-birth-weight ;fungemia
日期 2005-06
上傳時間 27-Feb-2014 16:19:08 (UTC+8)
摘要 Background: Prophylactic administration of fluconazole has been demonstrated to be effective in reducing systemic fungal infection in extremely-low-birth-weight (ELBW) infants. This study investigated the effects and side effects of this regimen in a tertiary care center Methods: ELBW infants younger than 5 days old admited to the Neonatal Intensive Care Unit of a university hospital between May 2000 and April 2004 were enrolled. Period A, May 2000 to April 2002, was used as the baseline. Period B, May 2002 to April 2004, was the period of fluconazole prophylaxis. Fluconazole (3 mg/kg) was administered intravenously every 72 h in the first 2 wks of life, every 48 h at 3-4 wks, and every 24 h at 5-6 wks. Laboratory parameters were recorded weekly for 7 weeks. Patient data, including predisposing factors, incidence of systemic infections, and blood chemistry tests in ELBW infants were compared between Period A and B. Results: There were 49 ELBW infants in period A and 57 infants in period B. The mean gestational age, birth weight, antenatal interventions, and delivery modes of the infants were similar in both groups. There were no significant differences in the distribution of risk factors between periods. However nine patients (18.4%) developed fungemia during period A, and 4 patients (7.0%) during period B. Only two (3.5%) contracted fungemia during chemoprophylaxis. The incidence of fungemia was lower in period B (0.65 per 1000 patient-days) than in period A (3.54 per 1000 patient-days). (95% C.I. -5.37 to -0.41 per 1000 patient-days, p=0.01). The age at onset of fungemia (36.3±8.7 days) in period B was significantly older than in period A (20.6±4.1 days, p=0.04). There was no fungemia-related mortality in period B. In contrast, 5 patients (55%) with fungemia died, and 2 (22%) had fungus-related mortality in period A. Conclusions: Early prophylaxis with fluconazole in ELBW infants decreased the incidence of fungemia without increasing adverse events. Whether a prolonged duration of medication would provide better coverage requires further study.
關聯 Clinical Neonatology, 12(1), 6-12
資料類型 article
dc.contributor 風管系en_US
dc.creator (作者) Tsai,Cheng-Hsien ;Cheng,Ching-Lan ;Lin,Yuh-Jyh ;Liu,Ching-Chuan ;Kao,Yea-Huei ;Lin,Chyi-Heren_US
dc.creator (作者) 蔡政憲;鄭靜蘭;林毓志;劉清泉;高雅慧;林其和zh_TW
dc.date (日期) 2005-06en_US
dc.date.accessioned 27-Feb-2014 16:19:08 (UTC+8)-
dc.date.available 27-Feb-2014 16:19:08 (UTC+8)-
dc.date.issued (上傳時間) 27-Feb-2014 16:19:08 (UTC+8)-
dc.identifier.uri (URI) http://nccur.lib.nccu.edu.tw/handle/140.119/64284-
dc.description.abstract (摘要) Background: Prophylactic administration of fluconazole has been demonstrated to be effective in reducing systemic fungal infection in extremely-low-birth-weight (ELBW) infants. This study investigated the effects and side effects of this regimen in a tertiary care center Methods: ELBW infants younger than 5 days old admited to the Neonatal Intensive Care Unit of a university hospital between May 2000 and April 2004 were enrolled. Period A, May 2000 to April 2002, was used as the baseline. Period B, May 2002 to April 2004, was the period of fluconazole prophylaxis. Fluconazole (3 mg/kg) was administered intravenously every 72 h in the first 2 wks of life, every 48 h at 3-4 wks, and every 24 h at 5-6 wks. Laboratory parameters were recorded weekly for 7 weeks. Patient data, including predisposing factors, incidence of systemic infections, and blood chemistry tests in ELBW infants were compared between Period A and B. Results: There were 49 ELBW infants in period A and 57 infants in period B. The mean gestational age, birth weight, antenatal interventions, and delivery modes of the infants were similar in both groups. There were no significant differences in the distribution of risk factors between periods. However nine patients (18.4%) developed fungemia during period A, and 4 patients (7.0%) during period B. Only two (3.5%) contracted fungemia during chemoprophylaxis. The incidence of fungemia was lower in period B (0.65 per 1000 patient-days) than in period A (3.54 per 1000 patient-days). (95% C.I. -5.37 to -0.41 per 1000 patient-days, p=0.01). The age at onset of fungemia (36.3±8.7 days) in period B was significantly older than in period A (20.6±4.1 days, p=0.04). There was no fungemia-related mortality in period B. In contrast, 5 patients (55%) with fungemia died, and 2 (22%) had fungus-related mortality in period A. Conclusions: Early prophylaxis with fluconazole in ELBW infants decreased the incidence of fungemia without increasing adverse events. Whether a prolonged duration of medication would provide better coverage requires further study.en_US
dc.format.extent 552849 bytes-
dc.format.mimetype application/pdf-
dc.language.iso en_US-
dc.relation (關聯) Clinical Neonatology, 12(1), 6-12en_US
dc.subject (關鍵詞) Fluconazole ;chemoprophylaxis ; extremely-low-birth-weight ;fungemiaen_US
dc.title (題名) Effects of Fluconazole Prophylaxis Against Systemic Fungal Infection in Extremely-low-birth-weight Infantsen_US
dc.title.alternative (其他題名) 投予預防性Fluconazole對降低極低體重兒全身性黴菌感染成效評估en_US
dc.type (資料類型) articleen