Fungal Infections Systemic Clinical Trial
Official title:
Oral Nystatin Prophylaxis to Prevent Systemic Fungal Infection in Very Low Birth Weight Preterm Infants: a Randomized Controlled Trial
This study determines the effectiveness of oral nystatin as prophylaxis in order to prevent systemic fungal infection in very low birth weight preterm neonates. 47 participants received oral nystatin and 48 participants received sterile water as part of oral hygiene.
Oral nystatin is an effective and safe alternative fungal prophylaxis. Some previous studies
(1 randomized controlled trial and 4 observational studies) showed that oral nystatin
prophylaxis reduce fungal colonization and decrease risk of systemic fungal infection in very
low birth weight infants.
Nystatin is a non-absorbable antifungal agent with minimal side effects that works by binding
on the major component of fungus cell membrane and causes death of the fungus. Its efficacy
as fungal prophylaxis is comparable with Fluconazole but does not linked to drug-induced
liver injury.
To determine this effectivity, we recruit eligible neonates who are admitted in our neonatal
intensive care unit and randomly assign them into 2 groups once noted written parental
consent. One group is given nystatin via oral and/or orogastric tube and the other group only
receives sterile water as part of oral hygiene. Weekly fungal surveillance cultures
(oropharyngeal and rectal) are done to evaluate colonization. Further examinations
(blood/cerebrospinal fluid/deep tissue/urine culture) are done once noted clinical signs of
systemic fungal infections.
Data analysis is conducted with intent-to treat approach. Significance testing is done by
chi-square or fisher's exact test as needed.
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