New research shows the drug fluconazole can help protect preterm babies from fungal infections in the first 30 days of life.
Preterm babies are born when a pregnancy lasts fewer than 37 weeks. There are many risks to preterm infants, and one of those is the risk of infection. Infection is a bigger threat to preemies because they’re not as able to fight off germs causing serious illness like full-term infants can. Infections can be passed from the mother before birth, during the birthing process or after birth.
Fungal infections coming primarily from Candida species, types of yeast fungi, are a major threat to preterm babies’ health. Candida species make their home in up to 60 percent of very-low-birth-weight preemies during their first month of life in the neonatal intensive care unit. Researchers say this fungal colonization may progress to invasive fungal infection in up to 20 percent of babies. Fungal infections increase the risk of death among preemies.
Italian researchers are studying the drug fluconazole as a way to prevent these infections from occurring. In the study, 322 infants weighing less than 1,500 grams at birth received either 3 milligrams of fluconazole, 6 milligrams of fluconazole, or a placebo from birth to the 30th day of life.
Results of the study show among infants who received the highest dose of fluconazole, fungal colonization occurred in 9.8 percent of the group. Among those receiving the lower dose, fungal colonization occurred in just 7.7 percent of the group. This was compared to 29.2 percent of those in the placebo group. The incidence of invasive fungal infection was 2.7 percent in the higher dose group, 3.8 percent in the low dose group, and 13.2 percent in the placebo group.
Authors of the study write, “Prophylactic fluconazole prevents colonization and infection by Candida species in very-low-birth-weight infants. In our study, fluconazole was effective in preventing rather than treating colonization.”
SOURCE: The New England Journal of Medicine, 2007;356:2483-2495
