Efficacy and safety of fluconazole in prophylaxis of invasive fungal infections in very low birth weight infants: a Meta analysis

Abstract:

Objective To assess the efficacy and safety of fluconazole in the prophylaxis of invasive fungal infection in very low birth weight (VLBW) infants. Methods Databases including PubMed, Embase, the Cochrane Library, Wanfang Data, Weipu, and CNKI were searched for randomized controlled trials (RCTs) of prophylactic fluconazole in VLBW infants. Review Manager 5.3 software was used to perform a Meta analysis of the included studies. Results A total of 12 RCTs were included, involving 1 679 VLBW infants. The Meta analysis showed that prophylactic fluconazole significantly reduced the incidence of invasive fungal infection (RR=0.44, 95%CI:0.27-0.71, P < 0.001), the incidence of fungal colonization (RR=0.31, 95%CI:0.24-0.40, P < 0.001), and the mortality during hospitalization (RR=0.74, 95%CI:0.58-0.94, P=0.01) compared with the control group. There were no significant differences between VLBW infants using different doses of fluconazole in the incidence of invasive fungal infection and fungal colonization (P > 0.05). No significant differences were found in the incidence of fluconazole resistance and complications between the fluconazole and control groups (P > 0.05). Conclusions Prophylactic fluconazole can effectively and safely prevent invasive fungal infection in VLBW infants, even at a small dose.