Fluconazole prophylaxis in extremely low birth weight infants and neurodevelopmental outcomes and quality of life at 8 to 10 years of age.
Author(s): Kaufman DA, Cuff AL, Wamstad JB, Boyle R, Gurka MJ, Grossman LB, Patrick P
Affiliation(s): Pediatrics, University of Virginia School of Medicine, Charlottesville, VA 22908, USA. email@example.com
Publication date & source: 2011-05, J Pediatr., 158(5):759-765.e1. Epub 2010 Dec 18.
Publication type: Comparative Study; Randomized Controlled Trial
OBJECTIVE: To examine the long-term effects of fluconazole prophylaxis in extremely low birth weight infants. STUDY DESIGN: Neurodevelopmental status and quality of life of survivors from a randomized, placebo-controlled trial of fluconazole prophylaxis were evaluated at 8 to 10 years of life using the Vineland Adaptive Behavior Scales-II (VABS-II) and the Child Health Questionnaire Parent-Completed Form 28 (CHQ-PF28), respectively. RESULTS: VABS-II Domain Scores for the fluconazole-treated (n = 21; 9.1 +/- 0.7 years) compared with the placebo group (n = 17; 9.3 +/- 0.8 years) were similar for communication [94.6 (+/-14.8) versus 92.6 (+/-12.6), P = .65], daily living skills [87.9 (+/-10.6) versus 87.4 (+/-9.3), P = .89], socialization [97.2 (+/-9.2) versus 94.4 (+/-7.9), P = .31], and motor skills [92.1 (+/-17.8) versus 95.1 (+/-14.6), P = .57]. Internalizing and externalizing behaviors and maladaptive behavior index were also similar. The CHQ-PF28 revealed no differences between the two groups regarding quality of life. Survivors were also happy or satisfied with school (90% versus 100%, P = .49), friendships (90% versus 88%, P = 1.00), and life (95% versus 100%, P = 1.00). Self esteem scores were 87.3 +/- 15.7 versus 89.7 +/- 10.4 (P = .59). There were also no differences between groups regarding emotional difficulties or behavior problems. CONCLUSIONS: Fluconazole prophylaxis for the prevention of invasive Candida infections is safe in extremely low birth weight infants and does not appear to be associated with any long-term adverse effects on neurodevelopment and quality of life at 8 to 10 years of life. Copyright (c) 2011 Mosby, Inc. All rights reserved.