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Review
. 2021;26(2):115-122.
doi: 10.5863/1551-6776-26.2.115. Epub 2021 Feb 15.

Review of Fluconazole Treatment and Prophylaxis for Invasive Candidiasis in Neonates

Chi D Hornik, Deborah S Bondi, Nicole M Greene, M Petrea Cober, Barnabas John
Review

Review of Fluconazole Treatment and Prophylaxis for Invasive Candidiasis in Neonates

Chi D Hornik et al. J Pediatr Pharmacol Ther. 2021.

Abstract

Invasive candidiasis accounts for approximately 10% of nosocomial infections in preterm infants, with an incidence of 1% to 4% among neonatal intensive care unit (NICU) admissions and a mortality as high as 20% to 30%. These outcomes warrant improved treatment and prevention strategies for infants at highest risk. The Infectious Diseases Society of America provides guidelines on antifungal medications for the prophylaxis and treatment of candidiasis in NICUs; however, there are still variations in practice on the use of fluconazole for prophylaxis and treatment of invasive candidiasis. This review provides specific information regarding fluconazole activity, pharmacokinetics, and a literature evaluation of dosing strategies and comparisons to other treatments in the neonatal population.

Keywords: Candida; amphotericin B; antifungal agents; candidiasis; fluconazole; newborn; pharmacokinetics.

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Conflict of interest statement

Disclosures. CDH receives support for research from the NICHD-funded Pediatric Trials Network (HHSN2752010000031). MPC serves as a consultant for Baxter, BBraun, Fresenius-Kabi, and Wolters-Kluwer. The others authors declare no conflicts or financial interest in any product or service mentioned in the manuscript, including grants, equipment, medications, employment, gifts, and honoraria.

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