Fluconazole Treatment of Neonates and Infants with Severe Fungal Infections

Gürpınar, Arif; Balkan, Emin; Kılıç, Nizamettin; Kırıştıoğlu, İrfan; Avşar, I; Doğruyol, Hasan

doi:10.1177/030006059702500408

Cited by 10 publications

(12 citation statements)

References 6 publications

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“…It was reported that fluconazole appears to be safe and effective for treatment of systemic candidal infection in children. 32,33 Randomised-controlled trials support its use in the treatment of candidaemia, showing equivalent efficacy and a superior safety profile compared with amphotericin B. 34 Our results were similar to those reported by other authors.…”

Section: Discussionsupporting

confidence: 86%

“…Also, there was significantly different in mean length of hospitalisation before onset of the candidaemia among patients with C. albicans (23.6 days) and non-albicans species (17.0 days) (P = 0.01). Mean gestational age of neonates was 31.2 ± 5.3 weeks (range: [25][26][27][28][29][30][31][32][33][34][35][36][37][38][39]. Seventy-two per cent were premature newborns.…”

Section: Resultsmentioning

confidence: 99%

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Nosocomial candidaemia in children: results of a 9‐year study

Çelebi

Hacımustafaoğlu

Özdemır

et al. 2007

Mycoses

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The aim of this study was to determine changes in the incidence of nosocomial candidaemia and to evaluate the risk factors, demographic features, treatment and clinical outcome associated with candidaemia in a Turkish tertiary care paediatric unit within a 9-year period. The data of children who were diagnosed as nosocomial candidaemia, were examined in this study. Between January 1997 and December 2005, a total of 102 nosocomial candidaemia episodes were identified in 102 patients. The rate of nosocomial candidaemia in our clinic increased from 3.2 cases per 1000 admissions in 1997-1999, to 5.5 per 1000 admissions in 2000-2002 and to 6.9 per 1000 admissions in 2003-2005 (P = 0.003). The species most frequently causing candidaemia were Candida albicans (39.2%), Candida parapsilosis (21.6%) and Candida tropicalis (15.7%). The mortality of C. albicans (37.5%), was significantly higher than the mortality of non-albicans species (17.7%) (P = 0.04). Independent risk factors associated with candidaemia-related deaths by logistic regression analysis were disseminated candidiasis (odds ratio, 5.7; P = 0.01), paediatric intensive care unit stay (odds ratio, 8.1; P = 0.001), prolonged antibiotics therapy (odds ratio, 5.2; P = 0.014), use of total parenteral nutrition (odds ratio, 4.4; P = 0.038) and mechanical ventilation (odds ratio, 4.9; P = 0.01). The rate of nosocomial candidaemia in our clinic increased >2-fold during the study period.

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Section: Discussionsupporting

confidence: 86%

Section: Resultsmentioning

confidence: 99%

Nosocomial candidaemia in children: results of a 9‐year study

Çelebi

Hacımustafaoğlu

Özdemır

et al. 2007

Mycoses

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“…Studies in pediatric age group indicate that fluconazole is effective and safe in treatment of Candidemia. Accordingly, 40.6% of the patients in our study group were treated with fluconazole only as the first line of the treatment [18,19]. Additionally, 26.2% of the patients which had febrile neutropenia were treated with amphotericin B, while 15.3% received caspofungin, 9.6% received voriconazole, and 2.6% who had neonatal meningitis were treated with amphotericin B + flucytosine.…”

Section: Discussionmentioning

confidence: 97%

Analysis of 144 pediatric nosocomial candidaemia episodes over a four-year period

Kocabaş¹,

Çay²,

Dayar³

et al. 2020

Ann Clin Anal Med

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Aim: The term candidemia simply indicates the presence of Candida species in the blood. Candida spp. are important pathogens in neonatal intensive care unit (NICU) patients, critically ill patients, and those with underlying immunocompromising conditions. Material and Method: In this retrospective study, 144 nosocomial candidemia episodes of 106 pediatric patients who had been admitted to pediatric units of Çukurova Univesity Hospital from 2010 January to 2013 December were evaluated. These 106 children's demographic and clinical features, risk factors, blood and intravascular line cultures, antifungal resistance, treatment and clinical outcome were evaluated. Results: The most frequently isolated species were Candida parapsilosis (31.9%), C. albicans (29.2%).C. tropicalis (16.0%), C. kruseiandC. Famata (4.2%),C. Glabrata (3.5%). Risk factors of 106 pediatric patients with Candidemiae were investigated. The main risk factors for candidemia included the presence of intravascular (IV) lines (68.1%), multiple antibiotics therapy (79.1%), total parenteral nutrition (59.7%), nasogastric tube insertion (45.1%), mechanical ventilation (34.7%), admission to intensive care unit (32.6%), and neutropenia (22.9%). The overall mortality rate of candida species was 17.9%. Discussion: Regular surveillance of local Candida species, resistance profiles, and risk factors are important in order to identify patients at risk and to develop empirical treatment protocols to reduce the incidence and mortality of candidemia.

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“…Its favorable pharmacokinetic features include good penetration into the CSF, a high concentration of active drug in the urine and minimal toxicity 13,15 . Thus fluconazole appears to have an excellent safety profile for children 16 . We chose the combination of amphotericin B deoxycholate and fluconazole.…”

Section: Discussionmentioning

confidence: 99%

“…13,15 Thus fluconazole appears to have an excellent safety profile for children. 16 We chose the combination of amphotericin B deoxycholate and fluconazole. After initiating this regimen, our patient showed marked clinical improvement.…”

Section: Discussionmentioning

confidence: 99%

Cryptococcal meningitis in pediatric systemic lupus erythematosus

Liou

Chiu

Tseng

et al. 2003

Mycoses

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Cryptococcal meningitis is an uncommon but often fatal complication of systemic lupus erythematosus (SLE). We report on a 13-year-old girl with SLE using high-dose prednisolone for several months, presented to us with low grade fever, intermittent vomiting and headache. Physical examination, including papilloedema and meningeal irritation, was unremarkable. Serum and cerebrospinal fluid (CSF) cryptococcal antigen titer was 1: 128 by latex agglutination method. CSF culture yielded Cryptococcus neoformans. We used amphotericin B deoxycholate (a cumulative dose of 1.95 gm) and fluconazole (200 mg day-1) for 6 weeks. Clinical response was good. Then, we continued fluconazole 200 mg per qd as suppressive therapy for thirty-four months. There were no neurological sequelae or relapse after 20-month follow-up. Timely diagnosis and effective antifungal therapy could improve the prognosis of cryptococcal meningitis in SLE patients.

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Fluconazole Treatment of Neonates and Infants with Severe Fungal Infections

Cited by 10 publications

References 6 publications

Nosocomial candidaemia in children: results of a 9‐year study

Nosocomial candidaemia in children: results of a 9‐year study

Analysis of 144 pediatric nosocomial candidaemia episodes over a four-year period

Cryptococcal meningitis in pediatric systemic lupus erythematosus

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