출생 체중 1 kg 미만의 초 극소 저 체중 출생아에서 침습성 진균 감염증에 대한 Fluconazole 예방 요법의 효과 분석
Efficacy of Fluconazole Prophylaxis for Invasive Fungal Infection in Extremely Low Birth Weight Infants
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Background : An invasive fungal infection (IFI) is an important cause of morbidityand mortality in preterm infants with immature immune systems. In the present study, we evaluatedthe efficacy in preventing IFI and adverse effects of prophylactic fluconazole in extremelylow birth weight infants (ELBWIs). Methods : From January 2010 to July 2012, we conducted a chart review in a total of 106preterm infants with a birth weight less than 1 kg that were hospitalized in the neonatal intensivecare unit (NICU) of the Asan medical center. In May 2011, an unit policy on fluconazole prophylaxishad been implemented (3 mg/kg twice a week intravenous infusion) and we classified thestudy population into two groups; control group (admitted before the introduction of fluconazoleprophylaxis, n=71) and study group (admitted after the introduction of fluconazole prophylaxis,n=35). The incidence of IFI and the strains of infection were investigated and other outcome variables including mortality, morbidity, and adverse effects of fluconazole were also collected. Results : The incidence of IFI was 2.9% in the study group versus 19.7% in the control group(p<0.05). Logistic regression revealed that fluconazole prophylaxis significantly decreased therates of IFI (Odds ratio 0.082, p<0.05). There was no difference in the incidence of cholestasisbetween two groups and there was no evidence of hepatotoxicity of fluconazole. Conclusion : The prophylactic administration of fluconazole in ELBWIs revealed its effectivenessin preventing IFI without significant adverse effects.
Abstract
Background : An invasive fungal infection (IFI) is an important cause of morbidityand mortality in preterm infants with immature immune systems. In the present study, we evaluatedthe efficacy in preventing IFI and adverse effects of prophylactic fluconazole in extremelylow birth weight infants (ELBWIs). Methods : From January 2010 to July 2012, we conducted a chart review in a total of 106preterm infants with a birth weight less than 1 kg that were hospitalized in the neonatal intensivecare unit (NICU) of the Asan medical center. In May 2011, an unit policy on fluconazole prophylaxishad been implemented (3 mg/kg twice a week intravenous infusion) and we classified thestudy population into two groups; control group (admitted before the introduction of fluconazoleprophylaxis, n=71) and study group (admitted after the introduction of fluconazole prophylaxis,n=35). The incidence of IFI and the strains of infection were investigated and other outcome variables including mortality, morbidity, and adverse effects of fluconazole were also collected. Results : The incidence of IFI was 2.9% in the study group versus 19.7% in the control group(p<0.05). Logistic regression revealed that fluconazole prophylaxis significantly decreased therates of IFI (Odds ratio 0.082, p<0.05). There was no difference in the incidence of cholestasisbetween two groups and there was no evidence of hepatotoxicity of fluconazole. Conclusion : The prophylactic administration of fluconazole in ELBWIs revealed its effectivenessin preventing IFI without significant adverse effects.
참고문헌 (14)
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