Fluconazole therapy in neonatal candidemia

Am J Perinatol. 2000;17(8):411-5. doi: 10.1055/s-2000-13454.


We reviewed 62 episodes (from 59 infants) of neonatal candidemia that occurred between January 1994 and June 1999. Except 5 term babies, all infants were premature (median gestational age [GA], 30 weeks) and birth weight was less than 2,500 g (median, 1,300 g). Most infants had reported risk factors and other neonatal problems. The age at onset of candidemia ranged from 15 to 173 days with a median of 34 days. In addition to catheter removal, all but one infants received antifungal agents and candidemia was eradicated subsequently in 46 episodes (75%). Eighteen infants with 19 episodes ever received fluconazole therapy. Fluconazole was administered as the first line agent in 6 episodes and successfully cleared candidemia in 5 episodes. Fluconazole was used as an alternative agent in an additional 13 episodes after amphotericin B (am B) +/- flucytosine were given for a period without a satisfactory result and eradication of candidemia was achieved in 8 episodes subsequently. All 18 infants tolerated fluconazole well and no withdrawal was required on account of its adverse effect. In contrast, am B alone was administered as the first line agent in 55 episodes and successfully cleared candidemia in 32 episodes (58%). This retrospective analysis suggests that fluconazole appears to be safe in neonates and can be used as an alternative agent in treating neonatal candidemia. A large-scaled prospective study may be needed.

MeSH terms

  • Antifungal Agents / administration & dosage*
  • Candidiasis / drug therapy*
  • Drug Administration Schedule
  • Female
  • Fluconazole / administration & dosage*
  • Fungemia / drug therapy*
  • Humans
  • Infant
  • Infant, Newborn
  • Infant, Premature
  • Infusions, Intravenous
  • Male
  • Medical Records
  • Retrospective Studies
  • Treatment Outcome


  • Antifungal Agents
  • Fluconazole