[Neonatal candidiasis and liposomal amphotericin B treatment: our experience].

OBJECTIVE: Nosocomial Candidiasis in low birth weight (LBW) infants have increased. Toxic side effects limit the use of conventional Amphotericin B for treatment of fungal infections. The liposomal forms have lowered this risk considerably, even at higher doses. Our aim was to evaluate treatment response to liposomal Amphotericin B in neonates with Candidiasis.

PATIENTS AND METHODS: Fifteen neonates diagnosed both clinically and biologically of Candidiasis infection and who were treated with liposomal Amphotericin B from June 1994 through July 1997 were included. Duration of treatment, when culture became negative, secondary effects, complications, other medication, basal pathology and clinical course were analyzed.

RESULTS: Mean gestational age was 36 +/- 6 weeks and 60% were preterm. Mean age at diagnosis was 13.4 days. Eleven patients presented sepsis (1 C. Sp., 9 C. albicans and 1 C. parapsilosis). They were treated with liposomal Amphotericin B, starting dose 0.5-1 mg/kg/day). One patient had associated 5-fluorocytosine. Cultures became negative at approximately 13 days and mean duration of therapy was 21.13 days. Seven patients showed additional bacterial infections. Side effects during treatment were anemia and hypotension.

CONCLUSIONS: Liposomal Amphotericin B has been effective in the treatment of Candidiasis without toxic signs that can be attributed solely to the medication.