Abstract

Liposomal amphotericin B for treatment of neonatal fungal sepsis-experience from a tertiary care centre.

Author(s): Prasad P, Vishnu Bhat B, Adhisivam B, Rojo Joy, Bahubali DG, Shruthi B

Fungal sepsis is increasing in neonatal intensive care units. Traditionally used drugs like Amphotericin B is often associated with serious side effects. Liposomal Amphotericin B was proved to be a safe alternative in adults but there exists only limited data regarding its use in newborns. We analysed the data from our tertiary level neonatal intensive care unit during the period of November 2011 to October 2012. Only babies with clinical features of sepsis and positive fungal cultures were included in this study. Thirty five babies received liposomal Amphotericin B at a dose of 5 mg/kg once daily during this period. Serial blood cultures, blood counts, septic screening, renal and liver function tests were done before and after starting the treatment for all these babies. Candida albicans was the predominant organism isolated in these babies (55%).Candida glabrata and Candida parapsiliosis were the next. Treatment with liposomal Amphotericin B resulted in survival of 89% of septic babies affected with albicans and 83% of non-albicans. Mean duration of treatment was 18.6+/_1.2days for albicans and 19.1+/-1.2days for non albicans. Mean duration for culture negativity was 11.6+/_2.2 days for albicans and 12.0+/-2days for non albicans. No significant side effects were noted.

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