Prophylactic systemic antifungal agents to prevent mortality and morbidity in very low birth weight infants

Cleminson, Jemma; Austin, Nicola; McGuire, William

doi:10.1002/14651858.cd003850.pub5

Cited by 82 publications

(36 citation statements)

References 74 publications

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“…In resource-rich countries, risk reduction bundles are more readily accepted and implemented, with proven efficacy in CLABSI rate reduction. In resource limited settings, however, the CLABSI bundle uptake, implementation, and program sustainability are major (Bizzarro et al, 2010;Pronovost, 2008;Mimoz et al, 2007;Garland et al, 2008;Birch et al, 2010;Cleminson et al, 2015;Puopolo and Escobar, 2014;Sanderson et al, 2017;Kramer et al, 2017;Rosenthal et al, 2010. barriers to wider adoption of this best practice intervention (Table 2). Indeed, in a 2019 report, 5 of 16 sites (27%) in middleincome countries reported no CLABSI prevention bundle use .…”

Section: Limited-resource Settingsmentioning

confidence: 99%

Managing and preventing vascular catheter infections: A position paper of the international society for infectious diseases

Lutwick

Al-Maani

Mehtar

et al. 2019

International Journal of Infectious Diseases

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Section: Limited-resource Settingsmentioning

confidence: 99%

Managing and preventing vascular catheter infections: A position paper of the international society for infectious diseases

Lutwick

Al-Maani

Mehtar

et al. 2019

International Journal of Infectious Diseases

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“…Although it is non-toxic, easy to use, and less expensive (17,18,(22)(23)(24)(25)(26)(27), the validity and applicability of the latest meta-analysis of nystatin prophylaxis (28) were limited due to insufficient data and methodological problems (e.g. concealment, allocation, and blinding problems) (28,29). To date, 14 fluconazole trials were registered compared to five nystatin trials.…”

Section: Resultsmentioning

confidence: 99%

Oral Nystatin Prophylaxis To Prevent Systemic Fungal Infection In Very Low Birth Weight Preterm Infants : A Randomized Controlled Trial

Rundjan

Wahyuningsih

Oeswadi

et al. 2020

Preprint

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Background Systemic fungal infection (SFI) is one of leading causes of morbidity and mortality in very low birth weight (VLBW) preterm infants. Because early diagnosis of SFI is challenging due to nonspecific manifestations, prophylaxis becomes crucial. This study aimed to assess effectiveness of oral nystatin as an antifungal prophylaxis to prevent SFI in VLBW preterm infants. Methods A prospective, open-labelled, randomized controlled trial was performed in a neonatal intensive care unit (NICU) of an academic hospital in Indonesia. Infants with a gestational age < 32 weeks and/or birth weight of < 1500 grams with risk factors of fungal infection were assessed for eligibility and randomized to either an intervention group (nystatin) or control group. The intervention group received 1 ml of oral nystatin three times a day, and the control group received a dose of 1ml of sterile water three times a day. The incidence of fungal colonization and SFI were observed and evaluated during the six-week study period. Overall, mortality rates and nystatin-related adverse drug reactions during the study period were also documented. Results A total of 95 patients were enrolled. The incidence of fungal colonization was lower among infants in nystatin group compared to those in control group (29.79% and 56.25%, respectively; relative risk 0.559; 95% confidence interval 0.357-0.899; p-value=0.009). There were five cases of SFI, all of which were found in the control group (p-value=0.056). There was no difference in overall mortality between the two groups. No adverse drug reactions were noted during the study period. Conclusions Nystatin is effective and safe as an antifungal prophylactic medication in reducing colonization rates in the study population. Whilst the use of nystatin showed a potential protective effect against SFI among VLBW preterm infants, there was no statistical significant difference in SFI rates between groups.

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“…There are some high-risk units, in which the incidence of candidemia traditionally has been high, usually over 10% of the admitted cases. In this scenario, prophylaxis has been suggested for the prevention of infection [46].…”

Section: Neonatesmentioning

confidence: 99%

Invasive Candidiasis: Epidemiology and Risk Factors

Cortés¹,

Corrales²

2019

Fungal Infection

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Invasive candidiasis is a severe infection caused by the yeast of the genus Candida. This highly lethal infection can affect any organs, but it is usually identified by the growth of the yeast in bloodstream samples. Although C. albicans was the most frequently found species, there has been a global trend to the non-albicans isolates. The appearance of C. auris, a newly identified species around the world, is a cause of concern because of resistance to antifungals. In this chapter, the epidemiology and risk factors for the acquisition of candidemia and other forms of invasive candidiasis are reviewed, while showing the current knowledge of worldwide epidemiology.

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Prophylactic systemic antifungal agents to prevent mortality and morbidity in very low birth weight infants

Cited by 82 publications

References 74 publications

Managing and preventing vascular catheter infections: A position paper of the international society for infectious diseases

Managing and preventing vascular catheter infections: A position paper of the international society for infectious diseases

Oral Nystatin Prophylaxis To Prevent Systemic Fungal Infection In Very Low Birth Weight Preterm Infants : A Randomized Controlled Trial

Invasive Candidiasis: Epidemiology and Risk Factors

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