Empirical Therapy for Neonatal Candidemia in Very Low Birth Weight Infants

  • Benjamin Jr D
  • DeLong E
  • Steinbach W
 et al. 
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Abstract

Objective. Neonatal candidemia is often fatal. Empirical antifungal therapy is associated with improved survival in neonates and patients with fever and neutropenia. Although guidelines for empirical therapy exist for patients with fever and neutropenia, these do not exist for neonates. Methods. A multicenter, retrospective, cohort study was conducted of neonatal intensive care unit patients (N = 6172) who had a blood culture (N = 21 233) after day of life 3 and whose birth weight was [28 weeks. We developed a candidemia score on the basis of the ORs from the multivariable model. Children with a candidemia score [IMG]=" BORDER="0">2 points were classified as having a "positive" score, and a score of [IMG]=" BORDER="0">2 points had a sensitivity of 85% and a specificity of 47%. Conclusions. We developed a clinical predictive model for neonatal candidemia with high sensitivity and moderate specificity for candidemia. On the basis of our model, when a physician obtains a blood culture, the physician should consider providing antifungal therapy to neonates who are

Author-supplied keywords

  • Candida
  • Diagnosis
  • Fungus
  • Newborn
  • Prediction
  • Preterm

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Authors

  • Daniel K Benjamin Jr

  • Elizabeth R DeLong

  • William J Steinbach

  • Charles M Cotton

  • Thomas J Walsh

  • Reese H Clark

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