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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Effect of fluconazole prophylaxis on Candida fluconazole susceptibility in premature infants
Journal of Antimicrobial Chemotherapy, Volume 73, No. 12, Year 2018
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Description
Objectives Extremely premature infants are at high risk of developing invasive candidiasis; fluconazole prophylaxis is safe and effective for reducing invasive candidiasis in this population but further study is needed. We sought to better understand the effect of prophylactic fluconazole on a selection of fluconazole-resistant Candida species. Methods We evaluated the susceptibility to fluconazole of Candida isolates from premature infants (<750 g birth weight) enrolled in a multicentre, randomized, placebo-controlled trial of fluconazole prophylaxis. Candida species were isolated through surveillance cultures at baseline (study day 0-7), period 1 (study day 8-28) and period 2 (study day 29-49). Fluconazole MICs were determined for all Candida isolates. Results Three hundred and sixty-one infants received fluconazole (n = 188) or placebo (n = 173). After the baseline period, Candida colonization was significantly lower in the fluconazole group compared with placebo during periods 1 (5% versus 27%; P < 0.001) and 2 (3% versus 27%; P < 0.001). After the baseline period, two infants (1%) were colonized with at least one fluconazole-resistant Candida in each group. Median fluconazole MIC was similar in both treatment groups at baseline and period 1. However, in period 2, median MIC was higher in the fluconazole group compared with placebo (1.00 versus 0.50 mg/L, P = 0.01). There was no emergence of resistance observed and no patients developed invasive candidiasis with a resistant Candida isolate. Conclusions Fluconazole prophylaxis decreased Candida albicans and € non-albicans' Candida colonization and was associated with a slightly higher fluconazole MIC for colonizing Candida isolates. © The Author(s) 2018. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved.
Authors & Co-Authors
Kaufman, David Alan
United States, Charlottesville
University of Virginia
Schell, Wiley A.
United States, Durham
Duke University
Benjamin, Daniel Kelly
United States, Durham
Duke University
Arrieta, Antonio Carlos
Unknown Affiliation
Pammi, Mohan
Unknown Affiliation
Kennedy, Kathy A.
Unknown Affiliation
Sanchèz, Pablo José
Unknown Affiliation
Ezeanolue, Echezona Edozie
Unknown Affiliation
Statistics
Citations: 27
Authors: 8
Affiliations: 8
Identifiers
Doi:
10.1093/jac/dky353
ISSN:
03057453
Research Areas
Cancer
Maternal And Child Health
Study Design
Cross Sectional Study