The Brazilian Journal of Infectious Diseases The Brazilian Journal of Infectious Diseases
Braz J Infect Dis 2017;21:333-8 - Vol. 21 Num.3 DOI: 10.1016/j.bjid.2017.01.008
Review article
Fluconazole prophylaxis in preterm infants: a systematic review
Juliana Ferreira da Silva Riosa,, , Paulo Augusto Moreira Camargosb, Luísa Petri Corrêaa, Roberta Maia de Castro Romanellib
a Universidade Federal de Minas Gerais, Santa Efigênia, BH, Brazil
b Universidade Federal de Minas Gerais, Departamento de Pediatria, Santa Efigênia, BH, Brazil
Received 14 November 2016, Accepted 23 January 2017
Abstract
Objective

This article aims to review the use of antifungal prophylaxis with intravenous fluconazole in premature newborns and the occurrence of Invasive Candidiasis.

Methods

This is a systematic review with search at databases: PubMed, Capes Portal, Virtual Health Library (BVS – Biblioteca Virtual em Saúde)/Lilacs, Scopus and Cochrane. The keywords used were: “Antifungal”, “Candida” “Fluconazole prophylaxis” and “Preterm infants”.

Results

Invasive Candidiasis was evaluated in all the twelve items. In eleven of them, there was a statistically significant difference between the groups receiving prophylactic fluconazole, with lower frequency of Invasive Candidiasis, compared to placebo or no prophylaxis group. Colonization by Candida species was also evaluated in five studies; four of them presented statistically lower proportion of colonization in patients with Fluconazole prophylaxis, compared to placebo or no drugs. In one study, there was a significant difference, favoring the use of fluconazole, and reduction of death.

Conclusion

Studies indicate the effectiveness of prophylaxis with fluconazole, with reduction in the incidence of colonization and invasive fungal disease. The benefits of prophylaxis should be evaluated considering the incidence of candidiasis in the unit, the mortality associated with candidiasis, the safety and toxicity of short and long-term medication, and the potential for development of resistant pathogens.

Keywords
Antifungal, Candida, Fluconazole prophylaxis, Preterm infants
Braz J Infect Dis 2017;21:333-8 - Vol. 21 Num.3 DOI: 10.1016/j.bjid.2017.01.008