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Role of fluconazole prophylaxis in decreasing Candida infection and colonization among severely neutropenic children with hematological malignancies
Assiut Medical Journal. 2011; 35 (2): 239-246
in English | IMEMR | ID: emr-135787
ABSTRACT
To Assess the role of antifungal prophylaxis in decreasing Candida infection and colonization in severely neutropenic children with hematological malignancies. Sixty four patients with severe neutropenia are randomized equally into 2 groups on 11 basis either to receive fluconazole prophylaxis [study group], or to receive placebo [control group]. Fluconazole antifungal prophylaxis/ placebo It was continued for 6 weeks, and follow up of the patient done until either Prophylaxis success by recovery from severe neutropenia [ANC fungal infection; more than 4 days of persistent fever or drug toxicity. Candida cultures samples of the oropharynx, stool/ rectal swab, urine and blood were taken upon enrolment [baseline] and at discontinuation of the study drug [end of prophylaxis]. Antifungal prophylaxis is clinically, successful in 50% of study group in comparison to only 12.5% in control group at end of the study with highly significant difference [P= 0.000] between the two groups. The rate of Candida colonization in the study group is reduced from 93.75% at baseline to 81.25 at end of study in comparison to the rate of colonization from 93.75 at baseline% to 100% at end of study in the control group. Candidemia is detected in two patients in the study group in comparison to four patients in the control group at end of the study. Non Candida albicans species colonization is significantly increased in the study group at end of prophylaxis in comparison to the control group. Fluconazole prophylaxis reduces Candida colonization of the alimentary tract which may predispose to invastive fungal infections
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Index: IMEMR (Eastern Mediterranean) Main subject: Candidiasis / Fluconazole / Child / Antifoaming Agents / Neutropenia Limits: Female / Humans / Male Language: English Journal: Assiut Med. J. Year: 2011

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Index: IMEMR (Eastern Mediterranean) Main subject: Candidiasis / Fluconazole / Child / Antifoaming Agents / Neutropenia Limits: Female / Humans / Male Language: English Journal: Assiut Med. J. Year: 2011