Fluconazole prophylaxis prevents invasive fungal infection in high-risk, very low birth weight infants

Objectives To evaluate the benefit of fluconazole prophylaxis in preventing invasive fungal infection in very low birth weight (VLBW) infants with central vascular access. Study design A 3-year baseline period (1998 to 2000) was compared with a subsequent 3-year period (2001 to 2003) during which a different protocol for preventing invasive fungal infection was used. All infants with a birth weight < 1500 g and with central vascular access were eligible for the study. Fluconazole (Diflucan R) was administered for 28 days at a dose of 6 mg/kg every third day during the first week and daily after the first week. Results There were no significant differences between the baseline and the fluconazole groups in demographic characteristics or risk factors for fungal infection. Fungal infection developed in 9 of the infants in the baseline group and in none of those in the fluconazole group (P =.003). A trend of decreasing mortality rate between the 2 groups (12.6% vs 8.1%; P =.32) was observed but was not statistically significant. No adverse effects of fluconazole therapy were documented. Conclusions Fluconazole prophylaxis appeared to be beneficial in preventing invasive fungal infection in VLBW infants.