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Antifungal therapy for newborn infants with invasive fungal infection

Antifungal therapy for newborn infants with invasive fungal infection

Research output: Contribution to journalScientific review

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Authors

  • Linda Clerihew
  • William McGuire

Research units

    Info

    Original languageEnglish
    ???articleNumber???CD003953
    Pages-
    Number of pages15
    JournalCochrane Database of Systematic Reviews
    Journal publication date2012
    Journal number6
    DOIs
    StatePublished

    Abstract

    Background

    A variety of antifungal drugs, drug preparations and drug combinations are available to treat newborn infants with suspected or confirmed invasive fungal infection. There is a need to assess their relative merits.

    Objectives

    To assess the effect of treatment with different antifungal drugs, drug preparations or drug combinations on mortality and morbidity in newborn infants with suspected or confirmed invasive fungal infection.

    Search methods

    We used the standard search strategy of the Cochrane Neonatal Review Group. This included searches of the Cochrane Central Register of Controlled Trials (The Cochrane Library, 2012, Issue 2), MEDLINE, EMBASE, CINAHL (to March 2012), conference proceedings and previous reviews.

    Selection criteria

    Randomised and quasi-randomised control trials comparing one antifungal agent or combination of agents with another in newborn infants with suspected or confirmed invasive fungal infection.

    Data collection and analysis

    We extracted the data using the standard methods of the Cochrane Neonatal Review Group, with separate evaluation of trial quality and data extraction by each author, and synthesis of data using risk ratio and risk difference.

    Main results

    We identified only one small trial in which 24 newborn infants participated. This trial compared the use of fluconazole versus amphotericin B (plus 5-fluorocytosine if fungal meningitis present). The trial did not detect a statistically significant effect on mortality (risk ratio 0.73; 95% confidence interval 0.26 to 2.05).

    Authors' conclusions

    There are insufficient data to inform practice. Large randomised controlled trials are required to compare antifungal drugs, drug preparations or drug combinations for treating newborn infants with invasive fungal infection.

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