Fluconazole in the management of neonatal systemic candidiasis.

OBJECTIVE To evaluate the role of Fluconazole in the management of neonatal systemic candidiasis. DESIGN Descriptive, retrospective analysis. SUBJECTS 23 neonates diagnosed as systemic candidiasis based on clinical suspicion with blood and/or urine culture positive for candida were treated with Fluconazole (5 mg/kg/day) for > 7 days. RESULTS Babies had mean birth weight 1590 + 533 g, mean gestation 32.3 + 3.1 wks and fungal sepsis was diagnosed at a mean age of 14.3 + 7.9 days. Candida albicans (43.5%), C. tropicalis (21.7%), C. guillermondii (13%), C. parapsillosis (13%) and C. krusei (8.7%) were the species isolated. Fluconazole was effective in 82.3% cases with no side effects. Four resistant cases were C. parapsillosis (n = 2), C. albicans (n = 1) and C. guillermondii (n = 1) and there were three deaths, all in resistant cases though one death was unrelated to candidemia. CONCLUSION Fluconazole is a safe and effective drug for neonatal systemic candidiasis.