Journal article
Empiric Antifungal Therapy and Outcomes in Extremely Low Birth Weight Infants with Invasive Candidiasis
The Journal of pediatrics, Vol.161(2), pp.264-269.e2
08/2012
DOI: 10.1016/j.jpeds.2012.01.053
PMCID: PMC3380169
PMID: 22424952
Abstract
To assess the impact of empiric antifungal therapy for invasive candidiasis on subsequent outcomes in premature infants.
This was a cohort study of infants with a birth weight ≤1000 g receiving care at Neonatal Research Network sites. All infants had at least one positive culture for Candida. Empiric antifungal therapy was defined as receipt of a systemic antifungal on the day of or the day before the first positive culture for Candida was drawn. We created Cox proportional hazards and logistic regression models stratified on propensity score quartiles to determine the effect of empiric antifungal therapy on survival, time to clearance of infection, retinopathy of prematurity, bronchopulmonary dysplasia, end-organ damage, and neurodevelopmental impairment (NDI).
A total of 136 infants developed invasive candidiasis. The incidence of death or NDI was lower in infants who received empiric antifungal therapy (19 of 38; 50%) compared with those who had not (55 of 86; 64%; OR, 0.27; 95% CI, 0.08-0.86). There was no significant difference between the groups for any single outcome or other combined outcomes.
Empiric antifungal therapy was associated with increased survival without NDI. A prospective randomized trial of this strategy is warranted.
Details
- Title: Subtitle
- Empiric Antifungal Therapy and Outcomes in Extremely Low Birth Weight Infants with Invasive Candidiasis
- Creators
- Rachel G Greenberg - Department of Pediatrics, Duke University, Durham, NCDaniel K Benjamin - Department of Pediatrics, Duke University, Durham, NCMarie G Gantz - Research Statistics Unit, Research Triangle Institute International, Research Triangle Park, NCC. Michael Cotten - Department of Pediatrics, Duke University, Durham, NCBarbara J Stoll - Department of Pediatrics, Emory University, Atlanta, GAMichele C Walsh - Department of Pediatrics, Rainbow Babies & Children's Hospital, Case Western Reserve University, Cleveland, OHPablo J Sánchez - Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TXSeetha Shankaran - Department of Pediatrics, Wayne State University, Detroit, MIAbhik Das - Statistics and Epidemiology Unit, Research Triangle Institute International, Rockville, MDRosemary D Higgins - Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MDNancy A Miller - Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TXKathy J Auten - Department of Pediatrics, Duke University, Durham, NCThomas J Walsh - National Cancer Institute, National Institutes of Health, Bethesda, MDAbbot R Laptook - Department of Pediatrics, Women & Infant's Hospital, Brown University, Providence, RIWaldemar A Carlo - Department of Pediatrics, University of Alabama at Birmingham, Birmingham, ALKathleen A Kennedy - Department of Pediatrics, University of Texas Medical School at Houston, Houston, TXNeil N Finer - Department of Pediatrics, University of California San Diego, La Jolla, CAShahnaz Duara - Department of Pediatrics, University of Miami Miller School of Medicine, Miami, FLKurt Schibler - Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OHRichard A Ehrenkranz - Department of Pediatrics, Yale University School of Medicine, New Haven, CTKrisa P Van Meurs - Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CAIvan D Frantz - Department of Pediatrics, Tufts Medical Center, Boston, MADale L Phelps - Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, NYBrenda B Poindexter - Department of Pediatrics, Indiana University School of Medicine, Indianapolis, INEdward F Bell - Department of Pediatrics, University of Iowa, Iowa City, IAT. Michael O'Shea - Department of Pediatrics, Wake Forest University, Winston-Salem, NCKristi L Watterberg - Department of Pediatrics, University of New Mexico Health Science Center, Albuquerque, NMRonald N Goldberg - Department of Pediatrics, Duke University, Durham, NCP. Brian Smith - Department of Pediatrics, Duke University, Durham, NCNational Institute of Child Health and Human Development Neonatal Research Network
- Resource Type
- Journal article
- Publication Details
- The Journal of pediatrics, Vol.161(2), pp.264-269.e2
- DOI
- 10.1016/j.jpeds.2012.01.053
- PMID
- 22424952
- PMCID
- PMC3380169
- NLM abbreviation
- J Pediatr
- ISSN
- 0022-3476
- eISSN
- 1097-6833
- Publisher
- Elsevier Inc
- Grant note
- 1R01HD057956-02, 1R01FD003519-01, 1U10-HD45962-06, 1K24HD058735-01; HHSN267200700051C / neonatal clinical pharmacology 1K23HD060040-01 and 1R18AE000028-01 / Eunice Kennedy Shriver National Institute of Child Health and Human Development Thrasher Research Foundation
- Language
- English
- Date published
- 08/2012
- Academic Unit
- Stead Family Department of Pediatrics; Neonatology
- Record Identifier
- 9984093311102771
Metrics
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