Fluconazole treatment of neonates and infants with severe fungal infections not treatable with conventional agents
Abstract
Fluconazole was evaluated prospectively in 40 neonates and infants between the ages of 2 days and 3 months in whom conventional antifungal therapy was ineffective or contraindicated. The patients received therapy on an individual compassionate request basis for microbiologically documented or presumed fungal infection. The mean fluconazole dosage was 5.3 mg/kg/day (range 1-16 mg/kg/day) and the mean duration of therapy was 26 days (range 2-80 days). Efficacy was evaluated in neonates with proven fungal infection as documented by the presence of a pathogen at baseline. A positive clinical response was achieved in 97% (31/32) of the clinically evaluable patients; eradication of the fungal organism was achieved in 97% (30/31) of evaluable patients. Adverse events occurred in two patients (5%); therapy was not discontinued in either patient. These favorable safety and efficacy data are similar to results obtained with fluconazole in older children and adults.
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A dosage of fluconazole 5 mg/kg per day has been used safely and successfully in infants with low or very low birth weight treated for disseminated candidiasis.
“A dosage of 5 mg/kg per day has been used safely and successfully in this population [94].”
From Guidelines for Treatment of Candidiasis (2004) · cites this paper as [94]
Cites
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Candida: An Increasingly Important Pathogen in the Nursery
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Systemic Candidiasis in Very Low-Birth-Weight Infants (<1,500 Grams)
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Disseminated Fungal Infections in Very Low-Birth-Weight Infants: Therapeutic Toxicity
Baley, J. E., Kliegman, R. M., & Fanaroff, A. A. (1984) · PEDIATRICS · doi:10.1542/peds.73.2.153 · Cited by 137 · see citing works
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Fluconazole in the treatment of candidiasis in immunocompromised children
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Guidelines for Treatment of Candidiasis
Pappas, P. G., Rex, J. H., Sobel, J. D., Filler, S. G., Dismukes, W. E., Walsh, T. J., & Edwards, J. E. (2004) · Clinical Infectious Diseases · doi:10.1086/380796 · Cited by 1,440 · see citing works
Practice Guidelines for the Treatment of Candidiasis
Rex, J. H., Walsh, T. J., Sobel, J. D., Filler, S. G., Pappas, P. G., Dismukes, W. E., & Edwards, J. E. (2000) · Clinical Infectious Diseases · doi:10.1086/313749 · Cited by 927 · see citing works
Groll, A. H., Piscitelli, S. C., & Walsh, T. J. (1998) · Advances in pharmacology · doi:10.1016/s1054-3589(08)60129-5 · Cited by 377 · see citing works
- Authors
- Fasano, C., O'Keeffe, J., & Gibbs, D.
- Affiliations
- Pfizer (United States) (US)
- Venue
- European Journal of Clinical Microbiology & Infectious Diseases
- Published
- 1994-04
- Volume
- 13
- Issue
- 4
- Pages
- 351-354
- ISSN
- 0934-9723 (ISSN-L)
- 1435-4373
- OpenAlex
- W2021371083
- Cited by
- 72
- References
- 8
- Citations by year
- 2025: 1 · 2023: 1 · 2022: 1 · 2021: 1 · 2020: 1 · 2019: 1 · 2017: 1 · 2015: 3 · 2014: 3 · 2013: 5 · 2012: 2
- FWCI
- 2.56
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- European Journal of Clinical Microbiology & Infectious Diseases (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Infectious Diseases › Antifungal resistance and susceptibility
- Health Sciences › Medicine › Epidemiology › Fungal Infections and Studies
- Health Sciences › Medicine › Ophthalmology › Ocular Infections and Treatments
- Keywords
- fluconazole, neonatal fungal infection, antifungal therapy, treatment efficacy, drug safety, adverse events, compassionate use
- MeSH terms
- Age Factors, Body Weight, Candida, Candidiasis, Female, Humans, Infant, Infant, Low Birth Weight, Infant, Newborn, Male, Mycoses, Prospective Studies, Risk Factors, Time Factors, Fluconazole
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