[
    {
        "id": "osp-2758",
        "type": "article-journal",
        "title": "Comparing Fluconazole and Nystatin as Antifungal Prophylactics in Very Low Birth Weight Infants: A Randomized Clinical Trial",
        "author": [
            {
                "family": "Asgarzadeh",
                "given": "Leila"
            },
            {
                "family": "Mahallei",
                "given": "Majid"
            },
            {
                "family": "Gharehbaghi",
                "given": "Manizheh Mostafa"
            }
        ],
        "URL": "https://omanscience.com/en/articles/comparing-fluconazole-and-nystatin-as-antifungal-prophylactics-in-very-low-birth-weight-infants-a-randomized-clinical-trial",
        "language": "en",
        "issued": {
            "date-parts": [
                [
                    2024
                ]
            ]
        },
        "container-title": "Oman Medical Journal",
        "DOI": "10.5001/imj.2024.90",
        "publisher": "Oman Medical Specialty Board",
        "ISSN": "1999-768X",
        "abstract": "Objectives: Systemic fungal infections (SFIs) account for 12% of all late-onset sepsis among very low birth weight (VLBW) infants and result in adverse long-term neurodevelopmental outcomes among survivors. This study compared the prophylactic efficacies of systemic fluconazole or oral nystatin prophylaxis to prevent SFI in VLBW infants. Methods: In a randomized controlled clinical trial, 120 neonates with gestational age < 32 weeks and birth weight < 1500 g were randomly allocated in two groups. Patients in group A received fluconazole 3 mg/kg intravenously twice weekly from the first 72 hours of life. Patients in group B were administered oral nystatin 1 mL (100 000 units) every eight hours. The primary endpoint was SFI and its associated mortality rate during hospital stay. Results: The mean gestational age of the enrolled infants was 28.2±1.4 weeks. Demographic characteristics were similar in both groups. SFI was detected in six (5.0%) infants with three cases from each group. Three (2.5%) patients died, two of whom were in group B. Four (6.7%) patients in group B and one (1.7%) in group A were treated for retinopathy of prematurity (p = 0.040). Intraventricular hemorrhage was detected in brain ultrasound examination in three (5.0%) neonates in group B and seven (11.7%) in group A (p = 0.020). Conclusions: The intravenous fluconazole and oral nystatin were similarly effective in preventing SFIs in VLBW infants. Future studies are recommended with a larger number of patients before routine administration of nystatin prophylaxis."
    }
]