Adrenocortical insufficiency is not a problem in preterm infants treated with antifungal prophylaxis with fluconazole

作者：Costa S^*; Barone G; Vento G; Tirone C; Perelli S; Romagnoli C

来源：Acta Paediatrica, 2014, 103(6): E234-E237.

DOI：10.1111/apa.12613

• Adrenocortical insufficiency
• Fluconazole prophylaxis
• Fungal infections
• Preterm infants

AimFluconazole prophylaxis of invasive fungal infections is a cornerstone of neonatal care, but in vitro 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. %26lt;br%26gt;MethodsWe 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 27weeks or with a birth weight of 750g 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. %26lt;br%26gt;ResultsThe 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. %26lt;br%26gt;ConclusionFluconazole 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.

• 出版日期2014-6