Empiric antifungal therapy and outcomes in extremely low birth weight infants with invasive candidiasis.
Empiric antifungal therapy and outcomes in extremely low birth weight infants with invasive candidiasis.
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DOI：
10.1016/j.jpeds.2012.01.053
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发表时间：
2012-08
影响因子：
5.1
通讯作者：
Smith, P. Brian
中科院分区：
文献类型：
--
作者：
Greenberg, Rachel G.;Benjamin, Daniel K., Jr.;Gantz, Marie G.;Cotten, C. Michael;Stoll, Barbara J.;Walsh, Michele C.;Sanchez, Pablo J.;Shankaran, Seetha;Das, Abhik;Higgins, Rosemary D.;Miller, Nancy A.;Auten, Kathy J.;Walsh, Thomas J.;Laptook, Abbot R.;Carlo, Waldemar A.;Kennedy, Kathleen A.;Finer, Neil N.;Duara, Shahnaz;Schibler, Kurt;Ehrenkranz, Richard A.;Van Meurs, Krisa P.;Frantz, Ivan D., III;Phelps, Dale L.;Poindexter, Brenda B.;Bell, Edward F.;O'Shea, T. Michael;Watterberg, Kristi L.;Goldberg, Ronald N.;Smith, P. Brian
评估早产儿侵袭性念珠菌病的预防性抗真菌治疗对预后的影响。这是一项在新生儿研究网络中心接受护理的出生体重≤1000 g婴儿的队列研究。所有婴儿至少有一个阳性培养念珠菌。经验性抗真菌治疗定义为在首次念珠菌培养阳性当天或前一天接受全身性抗真菌治疗。我们建立了考克斯比例风险和逻辑回归模型，根据倾向评分四分位数分层，以确定经验性抗真菌治疗对生存率、感染清除时间、早产儿视网膜病变、支气管肺发育不良、终末器官损害和神经发育障碍（NDI）的影响。136名婴儿发生侵袭性念珠菌病。与未接受抗真菌药物治疗的婴儿相比，接受抗真菌药物治疗的婴儿死亡或NDI的发生率（19/38，50%）较低（55/86，64%;比值比=0.27 [95%置信区间0.08-0.86]）。两组之间的任何单一结局或其他综合结局均无显著差异。经验性抗真菌治疗与无NDI的生存率增加相关。这一策略的前瞻性随机试验是必要的。
To assess the impact of emperic antifungal therapy of invasive candidiasis on subsequent outcomes in premature infants. This was a cohort study of infants ≤1000 g birth weight cared for at Neonatal Research Network sites. All infants had at least 1 positive culture for Candida. Emperic antifungal therapy was defined as receipt of a systemic antifungal on the day of or the day before the first positive culture for Candida was drawn. We created Cox proportional hazards and logistic regression models stratified on propensity score quartiles to determine the effect of emperic antifungal therapy on survival, time to clearance of infection, retinopathy of prematurity, bronchopulmonary dysplasia, end-organ damage, and neurodevelopmental impairment (NDI). 136 infants developed invasive candidiasis. The incidence of death or NDI was lower for infants who received emperic antifungal therapy (19/38, 50%) compared with those who had not (55/86, 64%; odds ratio=0.27 [95% confidence interval 0.08–0.86]). There was no significant difference between the groups for any single outcome or other combined outcomes. Emperic antifungal therapy was associated with increased survival without NDI. A prospective randomized trial of this strategy is warranted.
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影响因子：
8
作者：
Benjamin, DK;Stoll, BJ;Goldberg, R
通讯作者：
Goldberg, R
影响因子：
3.6
作者：
Benjamin, DK;Miller, WC;Martin, PL
通讯作者：
Martin, PL
DOI：
10.7326/0003-4819-127-8_part_2-199710151-00064
发表时间：
1997-10-15
影响因子：
39.2
作者：
Rubin, DB
通讯作者：
Rubin, DB
影响因子：
1.6
作者：
PIZZO, PA;ROBICHAUD, KJ;COMMERS, JR
通讯作者：
COMMERS, JR
影响因子：
5.2
作者：
Parkins, Michael D.;Sabuda, Deana M.;Laupland, Kevin B.
通讯作者：
Laupland, Kevin B.