Fluconazole use in neonatal ICU not associated with long-term complications

Kaufman DA. J Pediatr. 2011;158:759-765.

Fluconazole prophylaxis use to prevent Candida infections in low birth weight babies appears to have no long-term adverse effects on quality of life or neurodevelopment of these children 8 to 10 years later.

Infants born prematurely or born at an extremely low birth weight (less than 1,000 g) are highly susceptible to invasive Candida infections, which in turn predispose these infants to higher morbidity and mortality rates.

David A. Kaufman, MD,of the Division of Neonatology, department of pediatrics at the University of Virginia School of Medicine, and colleagues examined the long-term effects of using fluconazole to prevent Candida, by following up with 38 of 86 survivors who were enrolled in a fluconazole trial at the University of Virginia between 1998 and 2000. Twenty-one of the patients in the follow-up were in the fluconazole group, and 17 were in the placebo group.

The evaluation showed little statistical variance between the groups in terms of communication, daily living skills, and socialization and motor skills. Survivors from both groups were also equally happy or satisfied with school, friendships and overall quality of life. Self-esteem scores between the groups were also comparable. Neither group showed any differences with emotional or behavioral problems.

Routine fluconazole prophylaxis appears warranted at nurseries in which aggressive implementation of infection control policy and judicious antibiotic use still do not reduce risk for invasive candidiasis in extremely low birth weight infants to below a few percent, Sarah Long, MD, a pediatric infectious disease physician based in Philadelphia, wrote in an accompanying editorial.

Disclosure: The researchers report no relevant financial disclosures.

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