Fluconazole prophylaxis prevents invasive fungal infection in high-risk, very low birth weight infants

J Pediatr. 2005 Aug;147(2):162-5. doi: 10.1016/j.jpeds.2005.02.020.


Objectives: To evaluate the benefit of fluconazole prophylaxis in preventing invasive fungal infection in very low birth weight (VLBW) infants with central vascular access.

Study design: A 3-year baseline period (1998 to 2000) was compared with a subsequent 3-year period (2001 to 2003) during which a different protocol for preventing invasive fungal infection was used. All infants with a birth weight < 1500 g and with central vascular access were eligible for the study. Fluconazole (Diflucan R) was administered for 28 days at a dose of 6 mg/kg every third day during the first week and daily after the first week.

Results: There were no significant differences between the baseline and the fluconazole groups in demographic characteristics or risk factors for fungal infection. Fungal infection developed in 9 of the infants in the baseline group and in none of those in the fluconazole group (P=.003). A trend of decreasing mortality rate between the 2 groups (12.6% vs 8.1%; P=.32) was observed but was not statistically significant. No adverse effects of fluconazole therapy were documented.

Conclusions: Fluconazole prophylaxis appeared to be beneficial in preventing invasive fungal infection in VLBW infants.

MeSH terms

  • Antifungal Agents / administration & dosage
  • Antifungal Agents / therapeutic use*
  • Candidiasis / prevention & control*
  • Clinical Trials as Topic
  • Cross Infection / prevention & control*
  • Drug Administration Schedule
  • Female
  • Fluconazole / administration & dosage
  • Fluconazole / therapeutic use*
  • Gestational Age
  • Humans
  • Infant, Newborn
  • Infant, Very Low Birth Weight
  • Intensive Care Units, Neonatal
  • Male
  • Risk Factors


  • Antifungal Agents
  • Fluconazole