Adrenocortical insufficiency is not a problem in preterm infants treated with antifungal prophylaxis with fluconazole. (26th March 2014)

• Record Type: Journal Article
• Authors: Costa, S; Barone, G; Vento, G; Tirone, C; Perelli, S; Romagnoli, C
• Is Part Of: Acta pædiatrica. Volume 103:Number 6(2014:Jun.)
• Page Start: e234
• Page End: e237
• Publication Date: 2014-03-26
• Subjects: Pediatrics -- Periodicals; Pediatrics; 618.92
• DOI: 10.1111/apa.12613
• Languages: English
• ISSNs: 0803-5253

Abstract

<abstract abstract-type="main" id="apa12613-abs-0001"> <title>Abstract</title> <sec id="apa12613-sec-0001" sec-type="section"> <title>Aim</title> <p>Fluconazole prophylaxis of invasive fungal infections is a cornerstone of neonatal care, but <italic>in vitro</italic> studies have shown that it inhibits corticosteroid production. This study assessed whether preterm infants demonstrated an association between fluconazole administration, and its duration, and symptoms of adrenocortical insufficiency.</p> </sec> <sec id="apa12613-sec-0002" sec-type="section"> <title>Methods</title> <p>We compared two groups who were treated before and after we introduced the use of fluconazole to our neonatal intensive care unit. Infants with a gestational age of ≤27 weeks or with a birth weight of ≤750 g were considered for the retrospective analysis. In order to assess whether the duration of prophylaxis was related to adrenocortical insufficiency, regression models were performed in all preterm infants in the fluconazole group.</p> </sec> <sec id="apa12613-sec-0003" sec-type="section"> <title>Results</title> <p>The fluconazole group (n = 37) and nonfluconazole group (n = 41) were compared. No differences were found in the percentage of infants with symptoms of adrenocortical insufficiency, such as hypotension or need of vasopressor therapy. The incidence of hypotension and the use of vasopressor therapy were not related to duration of fluconazole prophylaxis.</p> </sec> <sec id="apa12613-sec-0004" sec-type="section"> <title>Conclusion</title> <p>Fluconazole and it duration were not associated with the incidence of symptoms related to adrenocortical insufficiency. Further prospective trials are needed to better define the relationship between fluconazole and adrenocortical insufficiency.</p> </sec> </abstract>