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Efficacy of Prophylactic Fluconazole Therapy in Preterm and Very Low Birth Weight Neonates in Preventing Invasive Fungal Infection.

Phase 3
Completed
Conditions
Invasive Candidiases
Interventions
Drug: Saline
Registration Number
NCT05848492
Lead Sponsor
Services Institute of Medical Sciences, Pakistan
Brief Summary

Invasive fungal infection is detecting candida species in blood, cerebrospinal fluid, or urine. Clinical signs of invasive candidiasis may include lethargy, temperature instability, feeding intolerance, apnea, hypotension, respiratory distress, abdominal distension, and thrombocytopenia. Fungal infection has been associated with an increased risk of retinopathy of prematurity and chronic lung disease. Preterm and low birth weight infants have an immature immune system that predisposes them to infections with bacteria, viruses, and fungi. These infants usually require prolonged admission in the neonatal unit and there is often a need for the administration of broad-spectrum antibiotics which predisposes them to colonization with fungi that may invade to cause systemic disease8. Other risk factors for the development of invasive fungal infection include endotracheal intubation, abdominal surgery, the presence of a central venous catheter, administration of H2 antagonists, and steroids. Infection with Candida species is the third most common cause of bloodstream infection in premature infants. Mortality in preterm infants due to invasive candidiasis is around 20% and can be as high as 50% in infants weighing \<1500g at birth. Invasive candidiasis is the second most common infectious cause of death in extremely preterm infants. The present study was conducted to determine the incidence of invasive candidiasis among preterm and very low birth weight infants in our neonatal unit and to evaluate the efficacy of prophylactic fluconazole in preventing invasive fungal infection. Based on the results of the present study institutional guidelines may be designed in our neonatal unit relating to antifungal prophylaxis in preterm and very low birth weight infants.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
110
Inclusion Criteria
  • Preterm babies born less than 34 weeks of gestation
  • very low birth weight babies (weighing < 1500 g at birth)
  • Babies <72 hours of age
Exclusion Criteria
  • Babies >72 hours of life
  • Syndromic babies
  • Babies with suspected metabolic disorders

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
placebo groupSalineNormal Saline 2cc given intravenously
Prophylactic FluconazoleFluconazole12 mg/Kg loading dose of fluconazole given intravenously followed by 6 mg/Kg every 48 hours till 14 days of life, and then 6 mg/kg/day thereafter, for a total duration of 6 weeks (42 days).
Primary Outcome Measures
NameTimeMethod
Invasive candidiases2 weeks

Positive blood, cerebrospinal fluid, or urine culture for candida species will be regarded as invasive candidiasis.

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (1)

Services Hospital Lahore

🇵🇰

Lahore, Punjab, Pakistan

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