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Objectives: We assessed the impact of intravenous fluconazole prophylaxis (FP) in extremely low birthweight (ELBW[<1000 g]) infants on the incidence of and ou tcome from invasive candidiasis (IC) in all infants admitted to a neonatal inten sive care unit (NICU). Study design: Beginning April 1, 2002, FP was given to EL BW infants aged < 5 days admitted to the NICU of Woman’s Hospital of Texas. Inf ants in NICU in whom IC developed during the first 2 years of FP (FP period) wer e compared with those with IC during 2000-2001. Results: During 2000-2001 and the FP period, the incidence of IC in ELBW infants decreased from 7%(15 of 206) to 2%(5 of 240) (P = .01), and the IC-related mortality rate decreased from 1 2%(4 of 33) to 0 (0 of 40) (P = .04); the incidence of IC increased from 0.1%( 4 of 2806) to 0.2%(8 of 3372) in infants of birth weight ≥1000 g (P = .06), an d no IC-related deaths occurred. During the FP period, IC developed in older in fants (24 vs 12 days; P = .12) who had similar risk factors for IC. Conclusion: Invasive candidiasis occurred in our NICU in spite of FP and shifted to bigger,m ore mature infants who had a better outcome.
Objectives: We assessed the impact of intravenous fluconazole prophylaxis (FP) in extremely low birthweight (ELBW [<1000 g]) infants on the incidence of and ou tcome from invasive candidiasis (IC) in all infants admitted to a neonatal inten sive care unit (NICU). Study design: Beginning April 1, 2002, FP was given to EL BW infants aged <5 days admitted to the NICU of Woman’s Hospital of Texas. Infants in NICU in whom IC developed during the first 2 years of FP ( FP period), compared with those with IC during 2000-2001. Results: During 2000-2001 and the FP period, the incidence of IC in ELBW infants decreased from 7% (15 of 206) to 2% (5 of 240) (P = .01), and the IC-related mortality rate decreased from 1 2% (4 of 33) to 0 (0 of 40) (P = .04); the incidence of IC increased from 0.1% (4 of 2806 ) to 0.2% (8 of 3372) in infants of birth weight ≥ 1000 g (P = .06), an d no IC-related deaths occurred. During the FP period, IC developed in older in fants (24 vs 12 days; P = .12) who had sim Conclusion: Invasive candidiasis occurred in our NICU in spite of FP and shifted to bigger, m ore mature infants who had a better outcome.