Review of fluconazole treatment and prophylaxis for invasive candidiasis in neonates.
Invasive candidiasis accounts for approximately 10% of nosocomial infections in preterm infants, with an incidence of 1% to 4% among neonatal intensive care unit (NICU) admissions and a mortality as high as 20% to 30%. These outcomes warrant improved treatment and prevention strategies for infants at highest risk. The Infectious Diseases Society of America provides guidelines on antifungal medications for the prophylaxis and treatment of candidiasis in NICUs; however, there are still variations in practice on the use of fluconazole for prophylaxis and treatment of invasive candidiasis. This review provides specific information regarding fluconazole activity, pharmacokinetics, and a literature evaluation of dosing strategies and comparisons to other treatments in the neonatal population.
Hornik CD; Bondi DS; Greene NM; Cober MP; John B
Journal Of Pediatric Pharmacology & Therapeutics
2021
2021-02-15
Copyright. Pediatric Pharmacy Association. All rights reserved. For permissions, email: mhelms@pediatricpharmacy.org 2021.
review
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Review of fluconazole treatment and prophylaxis for invasive candidiasis in neonates.
amphotericin B; antifungal agents; Candida; candidiasis; DENTAL prophylaxis; fluconazole; FLUCONAZOLE; INVASIVE candidiasis; NEONATAL intensive care units; newborn; pharmacokinetics; PHARMACOKINETICS; PREMATURE infants
Invasive candidiasis accounts for approximately 10% of nosocomial infections in preterm infants, with an incidence of 1% to 4% among neonatal intensive care unit (NICU) admissions and a mortality as high as 20% to 30%. These outcomes warrant improved treatment and prevention strategies for infants at highest risk. The Infectious Diseases Society of America provides guidelines on antifungal medications for the prophylaxis and treatment of candidiasis in NICUs; however, there are still variations in practice on the use of fluconazole for prophylaxis and treatment of invasive candidiasis. This review provides specific information regarding fluconazole activity, pharmacokinetics, and a literature evaluation of dosing strategies and comparisons to other treatments in the neonatal population. [ABSTRACT FROM AUTHOR]
Hornik CD; Bondi DS; Greene NM; Cober MP; John B
Journal Of Pediatric Pharmacology & Therapeutics
2021
2021-02
Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s).
journalArticle
<a href="http://doi.org/10.5863/1551-6776-26.2.115" target="_blank" rel="noreferrer noopener">10.5863/1551-6776-26.2.115</a>
Comparison of two concentrations of amphotericin B bladder irrigation in the treatment of funguria in patients with indwelling urinary catheters
amphotericin B; antifungals; candiduria; clearance; Dosage; mycoses; oral fluconazole; Pharmacology & Pharmacy
The efficacy of amphotericin B bladder irrigation at two concentrations was studied. Patients with funguria (greater than or equal to 15,000 colony-forming units of yeast per milliliter of urine), an indwelling urinary catheter, and a physician order for amphotericin B continuous bladder irrigation were randomly assigned to receive 10 or 50 mg of amphotericin B per liter of sterile water as a continuous irrigation for 72 hours at the rate of 42 mL/hr. Before the bladder irrigation began, the indwelling catheter was changed to a three-way catheter. Repeat urine cultures were performed 24 hours after the irrigation was discontinued. A total of 28 patients were enrolled from November 1993 to May 1995. The rate of eradication of the infection was 100% in the 50-mg/L group and 67% in the 10-mg/L group. Subject enrollment was stopped prematurely because all the treatment failures occurred in the 10-mg/L group. Dose was the only variable significantly associated with outcome. Bladder irrigation with amphotericin B was more effective when the drug concentration was 50 mg/L rather than 10 mg/L.
Nesbit S A; Katz L E; McClain B W; Murphy D P
American Journal of Health-System Pharmacy
1999
1999-05
Journal Article
<a href="http://doi.org/10.1093/ajhp/56.9.872" target="_blank" rel="noreferrer noopener">10.1093/ajhp/56.9.872</a>