Characteristics of included studies
| Reference | Setting | Participants | Comparison epochs | Fluconazole dose regimen | Invasive fungal infection definition | Reported confounding variables |
|---|---|---|---|---|---|---|
| Bertini et al11 | Italy | VLBW infants, with CVL in situ | 1998–2000 (n=119) versus 2001–2003 (n=136) | 6 mg/kg every 72 h for 1 week then every 24 h for 3 weeks | Culture from blood (peripheral), urine (SPA or aseptic catheterisation), or CSF | No significant differences in BW or GA |
| Aghai et al12 | USA | ELBW infants with intravascular access | 2002–2005 (n=137) versus 1998–2002 (n=140) | 3 mg/kg every 72 h for 2 weeks, then every 48 h for 2 weeks, then every 24 h for 2 weeks | Not stated | No significant differences in BW or GA. Fewer infants received antenatal steroids and surfactant in the control epoch. |
| Manzoni et al13 | Italy | VLBW infants | 2001–2003 (n=240) versus 1998–2000 (n=225) | 6 mg/kg every 72 h for 1 week then every 24 h for 3 weeks (and until 6 weeks for ELBW infants) | Culture from blood (peripheral), urine (SPA or aseptic catheterisation), CSF, or CVL | No significant differences in GA. Infants in control epoch had higher BW |
| Uko et al14 | USA | VLBW infants, given antibiotics for >3 days | 2001–2002 (n=206) versus 2003–2004 (n=178) | 3 mg/kg every 72 h for 2 weeks then every 48 h for 2 weeks | Culture from blood, urine (sampling method not specified) or CSF | No significant differences in BW or GA. Infants in control era had higher CRIB scores and more exposure to antibiotics |
| McCrossan et al15 | Ireland | VLBW infants with CVL in situ, fungal colonisation or broad-spectrum antibiotic exposure | 2003–2004 (n=33) versus 2002–2003 (n=31) | 6 mg/kg every 72 h for 2 weeks then every 48 h until 3 weeks old, then every 24 h for up to 3 weeks | Culture from blood (peripheral), urine (SPA or aseptic catheterisation), CSF or CVL (if clinically ‘septicaemic’) | No significant differences in BW, GA or exposure to antibiotics |
| Wadhawan et al16 | USA | ELBW infants with intravascular access | 1998–2002 (n=229) versus 2002–2006 (n=241) | 3 mg/kg every 72 h for 2 weeks, then every 48 h for 2 weeks, then every 24 h for 2 weeks | Culture from blood or urine (sampling method not specified) | Baseline characteristics of infants not stated |
| Al Qurashi et al17 | Saudi Arabia | VLBW infants | 2003–2004 (n=94) versus 2005–2006 (n=102) | Dose not stated. Duration: up to 6 weeks | Not stated | No significant differences in BW or GA |
| Aziz et al 18 | USA | ELBW infants with intravascular access | 1997–2002 (n=88) versus 2002–2006 (n=123) | 3 mg/kg every 72 h for 2 weeks, then every 48 h for 2 weeks, then every 24 h for 2 weeks | Not stated | No significant differences in GA. Infants in control epoch had significantly higher BW |
| Healy et al19 | USA | ELBW infants with intravascular access | 2000–2001 (n= 206) versus 2002–2006 (n=448). | 3 mg/kg every 72 h for 2 weeks, then every 48 h for 2 weeks, then every 24 h for 2 weeks | Culture from blood (sampling method not specified) or CSF | Baseline characteristics of control epoch infants not stated |
| Kim et al20 | USA | VLBW infants with fungal colonisation | 2002–2004 (n=132) versus 2004–2006 (n=166) | 3 mg/kg every 48 h for 6 weeks | Not stated | Fewer infants received antenatal steroids and surfactant in the control epoch |
| Weitkamp et al21 | USA | Infants of gestation <26 weeks or BW <750 g with intravascular access | 2004–2005 (n=44) versus 2005–2006 (n=42) | 3 mg/kg twice weekly for up to 6 weeks | Culture from blood or urine (sampling method not specified) | No significant differences in BW or GA. Significantly more infants in control epoch exposed to cephalosporins |
BW, birth weight; CRIB, clinical risk index for babies; CSF, cerebrospinal fluid; CVL, central venous line; ELBW, extremely low birth weight; GA, gestational age at birth; SPA, suprapubic aspirate; VLBW, very low birth weight.