Clinical Microbiology and Antimicrobial Chemotherapy. 2003; 5(4):354-359
The aim of this study was to review published data on efficacy and safety of prophylaxis and empirical therapy with antifungals in neonates. We have found 37 reports on use of antimycotics in neonates, which had been published by June 2003. Of 37 reports 5 were clinical trials of antifungals for prophylaxis and empirical therapy of invasive candidiasis in neonates: 3 were prospective randomized controlled studies and 2 were prospective descriptive studies. One report represented metaanalysis. Fluconazole was shown to be a single drug that can be used for prophylaxis of invasive candidiasis in preterm and low-birthweight infants. However, at least four problems remain unresolved: drug of choice for the empirical antifungal treatment of invasive mycoses in neonates and optimal dose of fluconazole for primary prophylaxis of invasive candidiasis have not so far been determined; there are no clear recommendations on duration of antifungal prophylaxis; groups of neonatal patients at risk for invasive candidiasis have not yet been defined.