Prophylactic fluconazole is effective in preventing fungal colonization and fungal systemic infections in preterm neonates: a single-center, 6-year, retrospective cohort study.


OBJECTIVE:Despite the promising preliminary results observed in extremely low birth weight (ELBW) populations, the use of fluconazole to prevent fungal colonization and infection in preterm neonates in the NICU is still an open question and not yet recommended as a standard of care. We have reviewed our 6-year series to assess the effectiveness and safety of this form of prophylaxis. METHODS:This retrospective study consisted of 465 neonates who weighed < 1500 g at birth and were admitted to our NICU in the period 1998-2003. Those who were born between 1998 and 2000 and did not receive fluconazole prophylaxis (group A, n = 240) were compared with those who were born between 2001 and 2003 and treated with fluconazole until the 30th day of life (45th for neonates < 1000 g at birth; group B, n = 225). Weekly surveillance cultures were obtained from all patients. Incidence of fungal colonization, incidence of systemic fungal infection (SFI), rate of progression from colonization to infection, and mortality rates attributable to fungi were calculated for both groups and separately for neonates who were < 1000 g (ELBW) and were 1001 to 1500 g (NE-VLBW) at birth. RESULTS:Overall fungal colonization was significantly lower in group B (24.0%) than in group A (43.8%; relative risk [RR]: 0.406; 95% confidence interval [CI]: 0.273-0.605). The same was true of neonates with colonization in multiple sites (2.6% vs 5.8%) and of those with colonization from high-risk sites (5.8% vs 19.2%). SFI incidence was significantly lower in group B (10 of 225 cases; 4.4%) than in group A (40 of 240 cases; 16.7%; RR: 0.233; 95% CI: 0.113-0.447). Reduction of both colonization and SFI in group B was greater in the ELBW neonates and also significant in the NE-VLBW neonates. Rate of progression from colonization to infection was significantly lower in group B (0.17 vs 0.38; RR: 0.369; 95% CI: 0.159-0.815). Crude mortality rate attributable to Candida species was 1.7% (4 of 240) in group A vs 0% (0 of 225) in group B. Overall mortality rate (any cause before hospital discharge) was similar in the two groups (11.2% vs 10.6%), but in colonized infants (n = 159), it was significantly lower in group B (3.7% vs 18.1%; RR: 0.174; 95% CI: 0.039-0.778). The incidence of natively fluconazole-resistant fungal species did not increase over the years, and patterns of sensitivity to fluconazole remained the same. No adverse reaction related to fluconazole occurred. CONCLUSIONS:Prophylactic fluconazole significantly reduces the incidence of colonization and systemic infection by Candida species in both ELBW and NE-VLBW neonates and decreases the rates of progression from initial colonization to massive colonization and to systemic infection. All VLBW neonates may benefit from fluconazole prophylaxis.






Manzoni P,Arisio R,Mostert M,Leonessa M,Farina D,Latino MA,Gomirato G




Has Abstract


2006-01-01 00:00:00














  • A Centralized Approach for Practicing Genomic Medicine.

    abstract::Next-generation sequencing has revolutionized the diagnostic process, making broadscale testing affordable and applicable to almost all specialties; however, there remain several challenges in its widespread implementation. Barriers such as lack of infrastructure or expertise within local health systems and complex re...


    pub_type: 杂志文章


    authors: Biswas S,Medne L,Devkota B,Bedoukian E,Berrodin D,Izumi K,Deardorff MA,Tarpinian J,Leonard J,Pyle L,Gray C,Montgomery J,Williams T,Fortunato S,Weatherly J,McEldrew D,Kaur M,Raible SE,Wilkens A,Spinner NB,Skraban C

    更新日期:2020-03-01 00:00:00

  • Noise and light exposures for extremely low birth weight newborns during their stay in the neonatal intensive care unit.

    abstract:OBJECTIVES:The objectives of this study were to characterize noise and light levels for extremely low birth weight newborns throughout their stay in the NICU, evaluate factors influencing noise and light levels, and determine whether exposures meet recommendations from the American Academy of Pediatrics. METHODS:Sound...


    pub_type: 杂志文章


    authors: Lasky RE,Williams AL

    更新日期:2009-02-01 00:00:00

  • Expanding the availability of extracorporeal cardiopulmonary resuscitation.

    abstract::A healthy 14-year-old presented to an emergency department in Alaska, complaining of shortness of breath, chest pain, and 72 hours of malaise and headache. On admission, her blood pressure was 80/50 mm Hg, and she had cool extremities. Electrocardiography revealed wide-complex ventricular tachycardia. She underwent sy...


    pub_type: 杂志文章


    authors: McMullan DM

    更新日期:2013-03-01 00:00:00

  • Successful resection of localized intestinal lymphangiectasia post-Fontan: role of (99m)technetium-dextran scintigraphy.

    abstract::Intestinal lymphangiectasia is a well-recognized complication of the Fontan procedure, occurring in up to 24% of patients. Because of the loss of chylous fluid into the gut lumen, protein-losing enteropathy results as well as lymphopenia and hypogammaglobulinaemia. In some cases, dilated lymphatics in the intestinal s...


    pub_type: 杂志文章


    authors: Connor FL,Angelides S,Gibson M,Larden DW,Roman MR,Jones O,Currie BG,Day AS,Bohane TD

    更新日期:2003-09-01 00:00:00

  • Pediatrician's practice choices: differences between part-time and full-time practice.

    abstract::A national survey was used to study the differences in career and family patterns of pediatricians who work part-time (PT) vs those who work full-time (FT). A questionnaire mailed to 375 members of the American Academy of Pediatrics asked about age, marital status, number of children, type of practice, hours worked in...


    pub_type: 杂志文章


    authors: Fritz NE,Lantos JD

    更新日期:1991-10-01 00:00:00

  • Mental Health Problems and Risk of Suicidal Ideation and Attempts in Adolescents.

    abstract:BACKGROUND:Obtaining recent estimates of the prevalence of suicide-related outcomes across adolescence and its associated mental health problems (MHPs) is important for clinical practice. We estimated the prevalence of suicide-related outcomes at ages 13, 15, 17, and 20 years (2011-2018) in a contemporary population-ba...


    pub_type: 杂志文章


    authors: Orri M,Scardera S,Perret LC,Bolanis D,Temcheff C,Séguin JR,Boivin M,Turecki G,Tremblay RE,Côté SM,Geoffroy MC

    更新日期:2020-07-01 00:00:00

  • The medical cost of abusive head trauma in the United States.

    abstract:OBJECTIVES:Health consequences of shaken baby syndrome, or pediatric abusive head trauma (AHT), can be severe and long-lasting. We aimed to estimate the multiyear medical cost attributable to AHT. METHODS:Using Truven Health MarketScan data, 2003-2011, we identified children 0 to 4 years old with commercial or Medicai...


    pub_type: 杂志文章


    authors: Peterson C,Xu L,Florence C,Parks SE,Miller TR,Barr RG,Barr M,Steinbeigle R

    更新日期:2014-07-01 00:00:00

  • Outpatient Rehabilitation for Medicaid-Insured Children Hospitalized With Traumatic Brain Injury.

    abstract:OBJECTIVES:To describe the prevalence of postdischarge outpatient rehabilitation among Medicaid-insured children hospitalized with a traumatic brain injury (TBI) and to identify factors associated with receipt of services. METHODS:Retrospective cohort of children <21 years, hospitalized for a TBI between 2007 and 2012...


    pub_type: 杂志文章


    authors: Jimenez N,Symons RG,Wang J,Ebel BH,Vavilala MS,Buchwald D,Temkin N,Jaffe KM,Rivara FP

    更新日期:2016-06-01 00:00:00

  • The associations of suicide attempts in adolescents.

    abstract:OBJECTIVE:Suicide completion has increased in the United States among 15- to 24-year-olds from 4.5 per 100 000 (1950) to 13.2 per 100 000 (1990). Suicide attempts have been found to be associated with depression, substance use, overall number of life stressors, gender, and impulsive behaviors. We hypothesized that suic...


    pub_type: 杂志文章


    authors: Woods ER,Lin YG,Middleman A,Beckford P,Chase L,DuRant RH

    更新日期:1997-06-01 00:00:00

  • Self-referral and serious illness in children with fever.

    abstract:OBJECTIVE:The goal of this study was to evaluate parents' capability to assess their febrile child's severity of illness and decision to present to the emergency department. We compared children referred by a general practitioner (GP) with those self-referred on the basis of illness-severity markers. METHODS:This was ...


    pub_type: 杂志文章


    authors: van Ierland Y,Seiger N,van Veen M,van Meurs AH,Ruige M,Oostenbrink R,Moll HA

    更新日期:2012-03-01 00:00:00

  • Fetal growth restriction and chronic lung disease among infants born before the 28th week of gestation.

    abstract:OBJECTIVE:Improvement in survival of extremely premature infants over the past several decades has resulted in an increase in the number of infants with chronic lung disease (CLD). Historical neonatal exposures associated with CLD now less frequently precede the disease. There is now increasing interest in exposures an...


    pub_type: 杂志文章


    authors: Bose C,Van Marter LJ,Laughon M,O'Shea TM,Allred EN,Karna P,Ehrenkranz RA,Boggess K,Leviton A,Extremely Low Gestational Age Newborn Study Investigators.

    更新日期:2009-09-01 00:00:00

  • Returning a Genomic Result for an Adult-Onset Condition to the Parents of a Newborn: Insights From the BabySeq Project.

    abstract::The return of information from genomic sequencing in children, especially in early life, brings up complex issues around parental autonomy, the child's future autonomy, the best interest standard, and the best interests of the family. These issues are particularly important in considering the return of genomic results...


    pub_type: 杂志文章


    authors: Holm IA,McGuire A,Pereira S,Rehm H,Green RC,Beggs AH,BabySeq Project Team.

    更新日期:2019-01-01 00:00:00

  • A randomized trial of early versus standard inhaled nitric oxide therapy in term and near-term newborn infants with hypoxic respiratory failure.

    abstract:OBJECTIVE:Inhaled nitric oxide (iNO) reduces the use of extracorporeal membrane oxygenation (ECMO)/incidence of death in term and near-term neonates with severe hypoxic respiratory failure. We conducted a randomized, double masked, multicenter trial to determine whether administration of iNO earlier in respiratory fail...


    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验


    authors: Konduri GG,Solimano A,Sokol GM,Singer J,Ehrenkranz RA,Singhal N,Wright LL,Van Meurs K,Stork E,Kirpalani H,Peliowski A,Neonatal Inhaled Nitric Oxide Study Group.

    更新日期:2004-03-01 00:00:00

  • Association between bullying and psychosomatic problems: a meta-analysis.

    abstract:CONTEXT:In the last few years, there has been an increasing amount of research showing the concurrent and long-term consequences of bullying and being bullied by peers. OBJECTIVE. We performed a meta-analysis to quantify the association between involvement in bullying and psychosomatic complaints in the school-aged pop...


    pub_type: 杂志文章,meta分析


    authors: Gini G,Pozzoli T

    更新日期:2009-03-01 00:00:00

  • Left atrial myxoma: association with acute coronary embolization in an 11-year-old boy.

    abstract::An 11-year-old boy had clinical signs of an acute inferior wall myocardial infarction. On echocardiography, a left atrial myxoma was demonstrated. Coronary artery embolization from myxoma was confirmed by selective coronary arteriography. The tumor was removed 12 days after acute coronary embolization. The clinical va...


    pub_type: 杂志文章


    authors: Tanabe J,Williams RL,Diethrich EB

    更新日期:1979-05-01 00:00:00

  • American Academy of Pediatrics. Committee on Infecious Diseases. Prevention of Lyme disease.

    abstract::Lyme disease is currently the most frequently reported vector-borne illness in the United States, accounting for more than 95% of such cases. The purpose of this report is to provide recommendations for preventing Lyme disease, including the use of Lyme disease vaccine. Individuals can reduce their risk of Lyme diseas...


    pub_type: 指南,杂志文章,实务指引,评审



    更新日期:2000-01-01 00:00:00

  • Microstream capnography improves patient monitoring during moderate sedation: a randomized, controlled trial.

    abstract:BACKGROUND:Investigative efforts to improve monitoring during sedation for patients of all ages are part of a national agenda for patient safety. According to the Institute of Medicine, recent technological advances in patient monitoring have contributed to substantially decreased mortality for people receiving general...


    pub_type: 杂志文章,随机对照试验


    authors: Lightdale JR,Goldmann DA,Feldman HA,Newburg AR,DiNardo JA,Fox VL

    更新日期:2006-06-01 00:00:00

  • Thrombopoietin in the thrombocytopenic term and preterm newborn.

    abstract:OBJECTIVES:Neonatal thrombocytopenia occurs commonly in neonatal intensive care units. The role of the thrombopoietin (Tpo) system in normal neonatal platelet regulation and neonatal thrombocytopenia is not well understood. The purpose of our study was to: 1) determine the normal Tpo level at birth in healthy nonthromb...


    pub_type: 杂志文章


    authors: Albert TS,Meng YG,Simms P,Cohen RL,Phibbs RH

    更新日期:2000-06-01 00:00:00

  • Tracheostomies and assisted ventilation in children with profound disabilities: navigating family and professional values.

    abstract::Parental requests for gastrostomies, tracheostomies, or assisted ventilation in children with profound disabilities raise ethical concerns about children's interests, parental decision-making, and health care costs. The underlying concern for many relates to the perceived value of these children. Clinicians should mak...


    pub_type: 杂志文章


    authors: Wilfond BS

    更新日期:2014-02-01 00:00:00

  • Increased risk of gastrointestinal perforations in neonates mechanically ventilated with either face mask or nasal prongs.

    abstract::Twenty cases of gastrointestinal perforations not associated with necrotizing enterocolitis or a bowel obstruction (GPNN) were reviewed. Fifteen infants suffered perforations during cycle ventilation. Perforations were localized in the stomach, duodenum, ileum, and jejunum. To determine if the type of mechanical venti...


    pub_type: 杂志文章


    authors: Garland JS,Nelson DB,Rice T,Neu J

    更新日期:1985-09-01 00:00:00

  • Epidemiology of juvenile chronic arthritis in southwestern Sweden: a 5-year prospective population study.

    abstract::Previous epidemiological studies of juvenile chronic arthritis (JCA) report divergent results owing to differences in diagnostic criteria, patient retrieval, and study designs. To investigate incidence and prevalence of JCA in a total population, this prospective survey was performed in southwestern Sweden between 198...


    pub_type: 杂志文章


    authors: Gäre BA,Fasth A

    更新日期:1992-12-01 00:00:00

  • Diabetic autoimmune markers in children and adolescents with type 2 diabetes.

    abstract:BACKGROUND:There is an increase in the incidence of type 2 diabetes in children and adolescents. Absence of known diabetes autoimmune markers is sometimes required to confirm the diagnosis. OBJECTIVE:To identify clinical and autoimmune characteristics of type 2 diabetes in a pediatric population. METHOD:We report an ...


    pub_type: 杂志文章


    authors: Hathout EH,Thomas W,El-Shahawy M,Nahab F,Mace JW

    更新日期:2001-06-01 00:00:00

  • US Emergency Department Trends in Imaging for Pediatric Nontraumatic Abdominal Pain.

    abstract:OBJECTIVES:To describe national emergency department (ED) trends in computed tomography (CT) and ultrasound imaging for the evaluation of pediatric nontraumatic abdominal pain from 2007 through 2014. METHODS:We used data from the National Hospital Ambulatory Medical Care Survey to measure trends in CT and ultrasound u...


    pub_type: 杂志文章


    authors: Niles LM,Goyal MK,Badolato GM,Chamberlain JM,Cohen JS

    更新日期:2017-10-01 00:00:00

  • Variation in Family Experience of Pediatric Inpatient Care As Measured by Child HCAHPS.

    abstract:BACKGROUND:Making national comparisons of family experience of inpatient pediatric care has been limited by the lack of a publicly available survey. The Agency for Healthcare Research and Quality and Centers for Medicare & Medicaid Services commissioned development of the Child Hospital Consumer Assessment of Healthcar...


    pub_type: 杂志文章


    authors: Toomey SL,Elliott MN,Zaslavsky AM,Klein DJ,Ndon S,Hardy S,Wu M,Schuster MA

    更新日期:2017-04-01 00:00:00

  • Detection of Mycobacterium tuberculosis in clinical specimens from children using a polymerase chain reaction.

    abstract:OBJECTIVE:We evaluated the usefulness of the polymerase chain reaction (PCR) using the insertion sequence IS6110 as the target for DNA to detect Mycobacterium tuberculosis in clinical specimens from children. STUDY DESIGN:This was a prospective, controlled, blinded study comparing PCR on clinical specimens, mycobacter...


    pub_type: 临床试验,杂志文章,多中心研究


    authors: Smith KC,Starke JR,Eisenach K,Ong LT,Denby M

    更新日期:1996-02-01 00:00:00

  • Immunologic defects in patients with refractory sinusitis.

    abstract::Sixty-one patients with chronic sinusitis who were referred for an allergy evaluation were evaluated for immunologic competence including assessment of quantitative serum immunoglobulin levels, IgG subclass levels, and response to pneumococcal and Haemophilus influenzae vaccines. In addition to chronic sinus disease, ...


    pub_type: 杂志文章


    authors: Shapiro GG,Virant FS,Furukawa CT,Pierson WE,Bierman CW

    更新日期:1991-03-01 00:00:00

  • US National Longitudinal Lesbian Family Study: psychological adjustment of 17-year-old adolescents.

    abstract:OBJECTIVES:The objective of this study was to document the psychological adjustment of adolescents who were conceived through donor insemination by lesbian mothers who enrolled before these offspring were born in the largest, longest running, prospective, longitudinal study of same-sex-parented families. METHODS:Betwe...


    pub_type: 杂志文章


    authors: Gartrell N,Bos H

    更新日期:2010-07-01 00:00:00

  • Motivational Interviewing to Treat Overweight Children: 24-Month Follow-Up of a Randomized Controlled Trial.

    abstract:BACKGROUND:Pediatrician-led motivational interviewing can be an effective way of controlling BMI in overweight children in the short term. Its long-term efficacy is unknown. The primary aim was to determine whether the short-term (12-month) impact of family pediatrician-led motivational interviews on the BMI of overwei...


    pub_type: 杂志文章,随机对照试验


    authors: Broccoli S,Davoli AM,Bonvicini L,Fabbri A,Ferrari E,Montagna G,Panza C,Pinotti M,Storani S,Tamelli M,Candela S,Bellocchio E,Giorgi Rossi P

    更新日期:2016-01-01 00:00:00

  • Adolescent E-Cigarette, Hookah, and Conventional Cigarette Use and Subsequent Marijuana Use.

    abstract::: media-1vid110.1542/5799875103001PEDS-VA_2017-3616Video Abstract OBJECTIVES: Noncigarette tobacco products may confer a risk of marijuana use similar to combustible cigarettes. We examined whether adolescent electronic cigarette (e-cigarette), hookah, or combustible cigarette use is associated with initiating and cur...


    pub_type: 杂志文章


    authors: Audrain-McGovern J,Stone MD,Barrington-Trimis J,Unger JB,Leventhal AM

    更新日期:2018-09-01 00:00:00

  • Effectiveness of nebulized beclomethasone in preventing viral wheezing: an RCT.

    abstract:OBJECTIVE:The goal of this study was to evaluate the effectiveness of nebulized beclomethasone in preventing the recurrence of viral wheezing. METHODS:The study was designed as a randomized, double-blind, placebo-controlled trial. Outpatient children aged 1 to 5 years with at least 1 episode of viral wheezing in the l...


    pub_type: 杂志文章,多中心研究,随机对照试验


    authors: Clavenna A,Sequi M,Cartabia M,Fortinguerra F,Borghi M,Bonati M,ENBe Study Group.

    更新日期:2014-03-01 00:00:00