Fluconazole Doses Used for Prophylaxis of Invasive Fungal Infection in Neonatal Intensive Care Units: A Network Meta-Analysis

Leonart, Letícia Paula; Tonin, Fernanda S.; Ferreira, Vinicíus Lins; Penteado, Suelem Tavares da Silva; Motta, Fábio Araújo; Pontarolo, Roberto

doi:10.1016/j.jpeds.2017.02.039

Cited by 22 publications

(17 citation statements)

References 47 publications

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“…In contrast to the percentage of resistant isolates observed in 2008–2009 for isolates from this age group (0.0%) [56], 8.2% of the current isolates were resistant to fluconazole. This increased resistance may reflect the increased use of fluconazole prophylaxis and treatment in these groups of younger patients [16, 47, 60].…”

Section: Resultsmentioning

confidence: 99%

Twenty Years of the SENTRY Antifungal Surveillance Program: Results for Candida Species From 1997–2016

Pfaller

Diekema

Turnidge

et al. 2019

Open Forum Infectious Diseases

582

580

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Background The emergence of antifungal resistance threatens effective treatment of invasive fungal infection (IFI). Invasive candidiasis is the most common health care–associated IFI. We evaluated the activity of fluconazole (FLU) against 20 788 invasive isolates of Candida (37 species) collected from 135 medical centers in 39 countries (1997–2016). The activity of anidulafungin, caspofungin, and micafungin (MCF) was evaluated against 15 308 isolates worldwide (2006–2016). Methods Species identification was accomplished using phenotypic (1997–2001), genotypic, and proteomic methods (2006–2016). All isolates were tested using reference methods and clinical breakpoints published in the Clinical and Laboratory Standards Institute documents. Results A decrease in the isolation of Candida albicans and an increase in the isolation of Candida glabrata and Candida parapsilosis were observed over time. Candida glabrata was the most common non–C. albicans species detected in all geographic regions except for Latin America, where C. parapsilosis and Candida tropicalis were more common. Six Candida auris isolates were detected: 1 each in 2009, 2013, 2014, and 2015 and 2 in 2016; all were from nosocomial bloodstream infections and were FLU-resistant (R). The highest rates of FLU-R isolates were seen in C. glabrata from North America (NA; 10.6%) and in C. tropicalis from the Asia-Pacific region (9.2%). A steady increase in isolation of C. glabrata and resistance to FLU was detected over 20 years in the United States. Echinocandin-R (EC-R) ranged from 3.5% for C. glabrata to 0.1% for C. albicans and C. parapsilosis. Resistance to MCF was highest among C. glabrata (2.8%) and C. tropicalis (1.3%) from NA. Mutations on FKS hot spot (HS) regions were detected among 70 EC-R isolates (51/70 were C. glabrata). Most isolates harboring FKS HS mutations were resistant to 2 or more ECs. Conclusions EC-R and FLU-R remain uncommon among contemporary Candida isolates; however, a slow and steady emergence of resistance to both antifungal classes was observed in C. glabrata and C. tropicalis isolates.

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Section: Resultsmentioning

confidence: 99%

Twenty Years of the SENTRY Antifungal Surveillance Program: Results for Candida Species From 1997–2016

Pfaller

Diekema

Turnidge

et al. 2019

Open Forum Infectious Diseases

582

580

View full text Add to dashboard Cite

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“…As soon as sepsis is excluded, antibiotics must be discontinued. Prophylactic antifungal therapy (fluconazole/nystatin) has been shown to be effective in units where invasive fungal infections are common (over 5%) but new guidelines on this subject should be followed (44).…”

Section: Antibioticsmentioning

confidence: 99%

Turkish Neonatal Society guideline on the management of respiratory distress syndrome and surfactant treatment

2019

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Respiratory distress syndrome is the leading cause of respiratory failure in preterm infants. The incidence and severity of respiratory distress syndrome are inversely related to the gestational age of the newborn. The major underlying pathophysiologic mechanisms are surfactant deficiency and anatomic, structural immaturity of the lung. Recent improvements such as antenatal steroid treatment to enhance pulmonary maturity, appropriate resuscitation facilitated by placental transfusion and immediate use of continuous positive airway pressure for alveolar recruitment, early rescue administration of surfactant, ventilation with gentler modes to minimize damage to the immature lungs, and the other supportive therapies have significantly decreased respiratory distress syndrome-related morbidity and mortality. This guideline was addressed to overview the mentioned improvements in order to standardize respiratory distress syndrome management in neonatal intensive care units in Turkey.

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“…The recommended antifungal options and doses for prophylaxis in adults and children are summarised in Table 9. 42,60 However, the optimal duration of prophylactic treatment is not known. 61…”

Section: The Optimal Duration Of Prophylaxis Is Not Knownmentioning

confidence: 99%

Federation of Infectious Diseases Societies of Southern Africa guideline: Recommendations for the detection, management and prevention of healthcare-associated Candida auris colonisation and disease in South Africa

Govender

Avenant

Brink

et al. 2019

Southern African Journal of Infectious Diseases

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The reasons for the dramatic emergence of C. auris as a pathogen in healthcare settings are not clear. We know that East Asia, South Asia, Africa and South America have unique C. auris clades separated from other clades by tens of thousands of single nucleotide polymorphisms. 10 This is consistent with the hypothesis that C. auris emerged independently and simultaneously on several continents. While C. auris is likely to have an environmental reservoir outside the healthcare setting, this has yet to be established. Several intrinsic properties of the pathogen probably facilitated its rapid spread in hospitals. C. auris produces biofilms. 11,12,13 While this fungus Candida auris has been detected at almost 100 South African hospitals, causing large outbreaks in some facilities, and this pathogen now accounts for approximately 1 in 10 cases of candidaemia. The objective of this guideline is to provide updated, evidence-informed recommendations outlining a best-practice approach to prevent, diagnose and manage C. auris disease in public-and private-sector healthcare settings in South Africa. The 18 practical recommendations cover five focus areas: laboratory identification and antifungal susceptibility testing, surveillance and outbreak response, infection prevention and control, clinical management and antifungal stewardship.

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Fluconazole Doses Used for Prophylaxis of Invasive Fungal Infection in Neonatal Intensive Care Units: A Network Meta-Analysis

Cited by 22 publications

References 47 publications

Twenty Years of the SENTRY Antifungal Surveillance Program: Results for Candida Species From 1997–2016

Twenty Years of the SENTRY Antifungal Surveillance Program: Results for Candida Species From 1997–2016

Turkish Neonatal Society guideline on the management of respiratory distress syndrome and surfactant treatment

Federation of Infectious Diseases Societies of Southern Africa guideline: Recommendations for the detection, management and prevention of healthcare-associated Candida auris colonisation and disease in South Africa

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