Treatment of candidaemia in premature infants: comparison of three amphotericin B preparations

Linder, Nehama; Klinger, G; Shalit, Itamar; Levy, Itzhak; Ashkenazi, Shai; Haski, Gali; Levit, Orli; Sirota, Lea

doi:10.1093/jac/dkg419

Cited by 111 publications

(79 citation statements)

References 22 publications

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“…24,86 Improvement in rates of fungal clearance from 67 to 96% with the addition of a second antifungal agent has been noted. 87 There is debate regarding the need to remove central venous catheters (CVCs) in patients with invasive candidiasis. Improved outcomes have been noted in neonates with CVC removal.…”

Section: Management Of Candidiasismentioning

confidence: 99%

Recent Developments and Current Issues in the Epidemiology, Diagnosis, and Management of Bacterial and Fungal Neonatal Sepsis

2013

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The definition of neonatal sepsis is complicated by the frequent presence of noninfectious conditions that resemble those of sepsis, especially in very low-birth-weight (VLBW) preterm infants and by the absence of optimal diagnostic tests. Although growth of an organism from a sterile site is the "gold standard" for definitive diagnosis, it is not always possible to isolate a causative pathogen. Invasive infections can occur in seemingly asymptomatic neonates. Therefore, assessment of history and risk factors in combination with diagnostic tests are used to identify neonates who are more likely to be infected.The definitions of early onset sepsis (EOS) and late onset sepsis (LOS) are subject to subspecialist variation. Many investigators, including those who participate in the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Neonatal Network and the Vermont Oxford Network, define EOS by the onset of signs/symptoms and an associated positive culture at or before 72 hours of life. LOS is characterized by the onset of symptoms consistent with sepsis at greater than 72 hours of life. These classifications of EOS and LOS reflect the differing etiologies and proposed pathophysiology of pathogens commonly associated with the timing of Keywords ► neonatal sepsis ► invasive candidiasis ► epidemiology ► management AbstractIdentifying neonates with sepsis is complicated by variability in clinical presentation. The incidence of early onset sepsis (EOS) resulting from invasive group B streptococcal (GBS) infections has been notably reduced by the widespread delivery of intrapartum antibiotic prophylaxis. Rates of EOS attributable to non-GBS etiologies have remained constant, and ampicillin-resistant Escherichia coli has become more prevalent. Lateonset sepsis (LOS) attributable to gram-positive organisms including coagulase-negative Staphylococci and Staphylococcus aureus is associated with increased morbidity and mortality among premature infants. Invasive candidiasis is an emerging cause of LOS, especially among infants who receive broad-spectrum antimicrobial agents. Prophylactic fluconazole administration to very low-birth-weight (VLBW) neonates during the first 6 weeks of life prevents invasive candidiasis in neonatal intensive care units (NICU) with high rates of fungal infections. Targeted fluconazole prophylaxis may be beneficial in VLBW neonates who receive care in NICUs with lower rates of invasive fungal infections. Assessment of immune function, neutrophil markers, acute phase reactants, and utilization of sepsis screening scores may contribute to the management of sepsis. Maternal decolonization, antimicrobial stewardship, early enteral feeding, and optimal infection control practices are potential practical strategies for reducing the burden of neonatal sepsis.

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Section: Management Of Candidiasismentioning

confidence: 99%

Recent Developments and Current Issues in the Epidemiology, Diagnosis, and Management of Bacterial and Fungal Neonatal Sepsis

2013

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“…Linder e cols 8 , em Israel, registraram candidemia em 1.3% de 4.201 recém-nascidos admitidos em uma UTIN. A frequência de candidemia é maior nos estudos que incluem somente recém-nascidos de baixo peso, com variação de 2,2 a 12,9% nos recém nascidos com peso inferior a 1.500g e de 5,5% a 16,5% naqueles com menos de 1.000g 18 .…”

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Fatores de risco associados à colonização por Candida spp em neonatos internados em uma Unidade de Terapia Intensiva Neonatal brasileira

Borges

Soares

Brito

et al. 2009

Rev. Soc. Bras. Med. Trop.

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“…Los ensayos prospectivos se han hecho en base a L-amB donde la tasa de respuesta a tratamiento es comparable con anfo B-d (84 y 89%, respectivamente) 34 . Con el uso de L-amB no se describen efectos adversos significativos, salvo hipokalemia leve que se recupera pronto con el aporte de potasio [35][36][37] . Un grupo de expertos de la Sociedad Europea de Microbiología Clínica e Infectología (ESCMID) se refiere al uso de L-amB, en dosis de 2,5 a 7 mg/kg/día en RN con un adecuado perfil de seguridad 38 .…”

Section: Tratamientounclassified

“…Existen limitados datos en RN que avalen la utilidad de asociar un segundo antifúngico a la terapia 35 .…”

Section: Tratamientounclassified

Candidiasis invasoras en recién nacidos: diagnóstico, tratamiento y prevención

Izquierdo

Santolaya

2014

Rev. chil. infectol.

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Treatment of candidaemia in premature infants: comparison of three amphotericin B preparations

Abstract: ABCD and LamB appear to be effective, safe and well tolerated in premature infants with CBSI and renal dysfunction. Larger trials are needed before routine use can be recommended.

Cited by 111 publications

References 22 publications

Recent Developments and Current Issues in the Epidemiology, Diagnosis, and Management of Bacterial and Fungal Neonatal Sepsis

Recent Developments and Current Issues in the Epidemiology, Diagnosis, and Management of Bacterial and Fungal Neonatal Sepsis

Fatores de risco associados à colonização por Candida spp em neonatos internados em uma Unidade de Terapia Intensiva Neonatal brasileira

Candidiasis invasoras en recién nacidos: diagnóstico, tratamiento y prevención

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