Does the use of oral nonabsorbable antifungal prophylaxis reduce the incidence of fungal colonization and/or systemic infection in preterm infants?

Abstract

Background: Invasive fungal infection is a significant cause of mortality and morbidity in preterm infants. Oral nonabsorbable agents are used prophylactically, but the literature regarding their effectiveness has not been systematically reviewed. Objective: To determine if oral nonabsorbable antifungal prophylaxis reduces the incidence of fungal colonization and/or systemic infection in preterm infants. Methods: The literature was reviewed using the methodology for systematic reviews for the Consensus on Resuscitation Science adapted from the American Heart Association's International Liaison Committee on Resuscitation. Results: Five studies were reviewed. Three level of evidence 1 studies and two level of evidence 3/4 studies provided evidence that the prophylactic use of oral nonabsorbable antifungal agents can reduce the incidence of fungal colonization and/or systemic fungal infection in preterm infants. Conclusion: Prophylactic oral nonabsorbable antifungal medications are an acceptable approach to reduce colonization and invasive fungal infection in preterm infants in units with high baseline colonization rates. © 2013 Pulsus Group Inc. All rights reserved.